Provider Demographics
NPI:1295801454
Name:LANDAU-MILLIN, REBECCA S (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:S
Last Name:LANDAU-MILLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5480 WISCONSIN AVENUE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815
Mailing Address - Country:US
Mailing Address - Phone:301-922-1114
Mailing Address - Fax:
Practice Address - Street 1:5480 WISCONSIN AVENUE
Practice Address - Street 2:SUITE 225
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815
Practice Address - Country:US
Practice Address - Phone:301-922-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4443103T00000X
MD05144103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist