Provider Demographics
NPI:1134836638
Name:TRUMP, REBECCA (MS, LMT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TRUMP
Suffix:
Gender:F
Credentials:MS, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-6974
Mailing Address - Country:US
Mailing Address - Phone:610-763-1464
Mailing Address - Fax:
Practice Address - Street 1:1 VALE RD STE A
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2370
Practice Address - Country:US
Practice Address - Phone:443-683-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM04303225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist