Provider Demographics
NPI:1922497148
Name:MAXWELL, TOMECCIA (MH)
Entity Type:Individual
Prefix:MS
First Name:TOMECCIA
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2693
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32704-2693
Mailing Address - Country:US
Mailing Address - Phone:321-347-5748
Mailing Address - Fax:
Practice Address - Street 1:205 N PARK AVE
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4102
Practice Address - Country:US
Practice Address - Phone:321-347-5748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health