Healthcare Provider Details

I. General information

NPI: 1891199048
Provider Name (Legal Business Name): TORI URPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TORI SKUROW

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 E 30TH ST
BALTIMORE MD
21218-3934
US

IV. Provider business mailing address

4155 GLEN PARK RD
NOTTINGHAM MD
21236-1019
US

V. Phone/Fax

Practice location:
  • Phone: 410-889-0727
  • Fax: 410-889-0729
Mailing address:
  • Phone: 410-529-0348
  • Fax: 443-451-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0942L
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: