MEDICARE: TONI TAWES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1730796160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI TAWES

Provider Business Mailing Address
First Line	:	7926 N BOUNDARY RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3335
Country	:	US
Telephone Number	:	443-750-1294
Fax Number	:

Provider Business Practice Location Address
First Line	:	7926 N BOUNDARY RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3335
Country	:	US
Telephone Number	:	443-750-1294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	09/29/2020

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Directions to “ TONI TAWES ” Practice Location

Language	Start Address	Practice Location

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