Provider Demographics
NPI:1942920954
Name:NEVENGLOSKY, REBEKAH JOY (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JOY
Last Name:NEVENGLOSKY
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3035
Mailing Address - Country:US
Mailing Address - Phone:570-239-9592
Mailing Address - Fax:
Practice Address - Street 1:9550 BOYDS TURN RD
Practice Address - Street 2:
Practice Address - City:OWINGS
Practice Address - State:MD
Practice Address - Zip Code:20736-3515
Practice Address - Country:US
Practice Address - Phone:443-550-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07024OtherMD SLP LICENSE