Provider Demographics
NPI:1013534304
Name:RICE, TONJA (CHES)
Entity Type:Individual
Prefix:
First Name:TONJA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15100 PEPPERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3032
Mailing Address - Country:US
Mailing Address - Phone:240-605-6164
Mailing Address - Fax:
Practice Address - Street 1:15100 PEPPERIDGE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3032
Practice Address - Country:US
Practice Address - Phone:240-605-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health