Provider Demographics
NPI:1609317650
Name:BLEDMAN, RASHANTA ANEISHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:RASHANTA
Middle Name:ANEISHA
Last Name:BLEDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4281 CHAPEL LN
Mailing Address - Street 2:1216 SHOEMAKER BUILDING
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20742-0001
Mailing Address - Country:US
Mailing Address - Phone:301-892-6833
Mailing Address - Fax:
Practice Address - Street 1:4281 CHAPEL LN
Practice Address - Street 2:1216 SHOEMAKER BUILDING
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-892-6833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05256103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist