Provider Demographics
NPI:1821115361
Name:NABORS, ROSALIE ISAACSON (EDD, SLP/CCC)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:ISAACSON
Last Name:NABORS
Suffix:
Gender:F
Credentials:EDD, SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 RED CEDAR PL
Mailing Address - Street 2:UNIT 202
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-5400
Mailing Address - Country:US
Mailing Address - Phone:443-449-7755
Mailing Address - Fax:
Practice Address - Street 1:6350 RED CEDAR PL
Practice Address - Street 2:UNIT 202
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-5400
Practice Address - Country:US
Practice Address - Phone:443-449-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSLP429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS007OtherBLUE CROSS ANDBLUE SHIELD