Provider Demographics
NPI:1588227557
Name:ROZICS, ANDREA JEANNETTE (CCC-A)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEANNETTE
Last Name:ROZICS
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WINEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9138
Mailing Address - Country:US
Mailing Address - Phone:410-493-6324
Mailing Address - Fax:
Practice Address - Street 1:7855 TRAPPE RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-2347
Practice Address - Country:US
Practice Address - Phone:443-809-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD000552231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist