Provider Demographics
NPI:1891914859
Name:MARY ANNE LA TORRE
Entity Type:Organization
Organization Name:MARY ANNE LA TORRE
Other - Org Name:INNER VISIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHIATRIC CLINICAL NURSE SPECIALI
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LA TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MA
Authorized Official - Phone:410-648-5764
Mailing Address - Street 1:31546 SASSAFRAS RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:MD
Mailing Address - Zip Code:21635-1349
Mailing Address - Country:US
Mailing Address - Phone:410-648-5884
Mailing Address - Fax:
Practice Address - Street 1:31546 SASSAFRAS RIVER AVE
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:MD
Practice Address - Zip Code:21635-1349
Practice Address - Country:US
Practice Address - Phone:410-648-5764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR132273163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty