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General NPI Number Information
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NPI Number | 1083682702
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Entity Type | Individual
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Provider Name | JEFFREY TUCHMAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 200 E NORTH AVE RELATED SERVICES RM 210
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City | BALTIMORE
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State | MD
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Zip | 21202
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Country | US
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Telephone | 443-642-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 20 FOREST GLEN CT
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1631
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Country | US
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Telephone | 443-386-9604
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 08860
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License Number State | MD
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