Provider Demographics
NPI:1609565605
Name:TON-NU, MAIKA (ATR-P, LGPAT)
Entity Type:Individual
Prefix:
First Name:MAIKA
Middle Name:
Last Name:TON-NU
Suffix:
Gender:F
Credentials:ATR-P, LGPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 PINECREST AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-1636
Mailing Address - Country:US
Mailing Address - Phone:443-460-8858
Mailing Address - Fax:
Practice Address - Street 1:111 WARREN RD STE 5A
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3367
Practice Address - Country:US
Practice Address - Phone:443-595-7627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATG338221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist