Basic Information
Provider Information
NPI: 1003294232
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AARON
FirstName: RACHEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
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Mailing Information
Address1: 9910 FRANKLIN SQUARE DR STE 2110
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212364902
CountryCode: US
TelephoneNumber: 4109336423
FaxNumber:  
Practice Location
Address1: 600 N WOLFE STREET
Address2: MEYER 163
City: BALTIMORE
State: MD
PostalCode: 212870005
CountryCode: US
TelephoneNumber: 4106144030
FaxNumber: 4106144033
Other Information
ProviderEnumerationDate: 05/07/2015
LastUpdateDate: 06/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X06162MDY Behavioral Health & Social Service ProvidersPsychologistClinical
103TR0400X06162MDN Behavioral Health & Social Service ProvidersPsychologistRehabilitation

No ID Information.


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