Provider Demographics
NPI:1689300873
Name:TAMULA, MARY ANNE TOLEDO (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANNE
Middle Name:TOLEDO
Last Name:TAMULA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 WISCONSIN AVE STE 1528
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4300
Mailing Address - Country:US
Mailing Address - Phone:240-542-8503
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE STE 1528
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4300
Practice Address - Country:US
Practice Address - Phone:240-542-8503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0334103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty