Healthcare Provider Details

I. General information

NPI: 1952245672
Provider Name (Legal Business Name): NATASHA A TONGE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3318 ELM AVE
BALTIMORE MD
21211-2725
US

IV. Provider business mailing address

3318 ELM AVE
BALTIMORE MD
21211-2725
US

V. Phone/Fax

Practice location:
  • Phone: 347-220-9758
  • Fax:
Mailing address:
  • Phone: 347-220-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number06809
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: