Individual
MRS. GAIL DOROTHY VANDERBEEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
6901 N CHARLES ST, TOWSON, MD 21204-3780
(410) 887-5121
Mailing address
2420 DERBY DRIVE, FALLSTON, MD 21047
(410) 692-2404
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02631
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419800000
—
MD
01
—
54541702
CAREFIRST BCBS
MD
Enumeration date
03/05/2007
Last updated
05/29/2020
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