Provider Demographics
NPI:1770510158
Name:REDMOND, RONALD E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:E
Last Name:REDMOND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14613 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2373
Mailing Address - Country:US
Mailing Address - Phone:301-460-5037
Mailing Address - Fax:301-460-5037
Practice Address - Street 1:7925 - 9B GLENBROOK RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-466-8745
Practice Address - Fax:301-460-5037
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01300103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0000438383Medicare ID - Type UnspecifiedMEDICARE/MEDICAID