Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 012109-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 012109-1 | NY |
NPI | 1003260738 |
---|---|
Provider Name | Dr. Naomi Tomoyasu |
First Address | Ellicott City, MD 21042-5820 |
Second Address | Ellicott City, MD 21042-5820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 20/04/2016 |