Provider Demographics
NPI:1932629219
Name:POMYCALA, RACHEL MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARIE
Last Name:POMYCALA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 RITCHIE HWY STE I
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3926
Mailing Address - Country:US
Mailing Address - Phone:410-647-7795
Mailing Address - Fax:410-315-8823
Practice Address - Street 1:1324 BELMONT AVE STE 202
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4584
Practice Address - Country:US
Practice Address - Phone:410-546-9552
Practice Address - Fax:410-315-8823
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01422231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty