Provider Demographics
NPI:1548891500
Name:LENTZ, RACHEL JENNIFER (MS)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JENNIFER
Last Name:LENTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11908 RIDGE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1621
Mailing Address - Country:US
Mailing Address - Phone:410-925-5282
Mailing Address - Fax:
Practice Address - Street 1:3303 SAINT LUKES LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-5703
Practice Address - Country:US
Practice Address - Phone:410-807-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD05979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD05979Medicaid