Provider Demographics
NPI:1710144753
Name:TOWSON UNIVERSITY, STATE OF MARYLAND
Entity Type:Organization
Organization Name:TOWSON UNIVERSITY, STATE OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, IWB
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-704-3097
Mailing Address - Street 1:8000 YORK RD
Mailing Address - Street 2:INSTITUTE FOR WELL-BEING
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-7300
Mailing Address - Fax:410-704-6303
Practice Address - Street 1:8000 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:410-704-6303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF MARYLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02143225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty