Individual
TIFFANY CLAIRE VILLARTA LUMAYOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 E JOPPA RD, TOWSON, MD 21286-5404
(410) 828-9494
Mailing address
509 E JOPPA RD, TOWSON, MD 21286-5404
(410) 828-9494
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02677
MD
225XG0600X
Gerontology Occupational Therapist
A02677
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1559696656
MANAGED-CARE
MD
05
—
1559696656
—
MD
Enumeration date
10/11/2022
Last updated
10/11/2022
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