Provider Demographics
NPI:1538634910
Name:LONOZA, REBECCA NOELLE (PTA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NOELLE
Last Name:LONOZA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:NOELLE
Other - Last Name:PARDUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 MAPLE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:RISING SUN
Mailing Address - State:MD
Mailing Address - Zip Code:21911-1828
Mailing Address - Country:US
Mailing Address - Phone:443-907-2423
Mailing Address - Fax:
Practice Address - Street 1:122 MAPLE LEAF DR
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-1828
Practice Address - Country:US
Practice Address - Phone:443-907-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4994225200000X
PATEI005699225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant