Provider Demographics
NPI:1366021669
Name:JOSEPH, TOMY N/A
Entity Type:Individual
Prefix:
First Name:TOMY
Middle Name:N/A
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10080 FALL RAIN DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5764
Mailing Address - Country:US
Mailing Address - Phone:301-769-8823
Mailing Address - Fax:
Practice Address - Street 1:10080 FALL RAIN DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-5764
Practice Address - Country:US
Practice Address - Phone:301-769-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker