Provider Demographics
NPI:1750834081
Name:DUNHAM, RACHEL BRENNA (AUD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:BRENNA
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:BRENNA
Other - Last Name:LIEBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-6151
Practice Address - Fax:443-287-6340
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01393231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist