Provider Demographics
NPI:1568162915
Name:TORRE, MARK ANTHONY JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANTHONY
Last Name:TORRE
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7328
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-7328
Mailing Address - Country:US
Mailing Address - Phone:671-483-1453
Mailing Address - Fax:
Practice Address - Street 1:140 CHALAN TOMAS ANDAI
Practice Address - Street 2:
Practice Address - City:YIGO
Practice Address - State:GU
Practice Address - Zip Code:96929-9692
Practice Address - Country:US
Practice Address - Phone:671-483-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker