Provider Demographics
NPI:1467607366
Name:GLICKMAN, REBECCA QUINN (MPT)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:QUINN
Last Name:GLICKMAN
Suffix:
Gender:
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-0500
Mailing Address - Country:US
Mailing Address - Phone:301-498-8100
Mailing Address - Fax:301-498-0009
Practice Address - Street 1:14235 PARK CENTER DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5261
Practice Address - Country:US
Practice Address - Phone:301-498-8100
Practice Address - Fax:301-498-0009
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8709362251P0200X
MD226912251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics