Provider Demographics
NPI:1851009096
Name:TAKOR, CECILIA BESEM (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:BESEM
Last Name:TAKOR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 MERRYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2250
Mailing Address - Country:US
Mailing Address - Phone:240-899-2683
Mailing Address - Fax:
Practice Address - Street 1:1726 REISTERSTOWN RD STE 212
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2987
Practice Address - Country:US
Practice Address - Phone:443-501-3204
Practice Address - Fax:443-501-3043
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235853363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health