| Doctor Name: | DR. NAOMI TOMOYASU |
| NPI Number: | 1003260738 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 012109-1 |
| Business Practice Address: | 10269 Bristol Channel Ellicott City, MD - 210425820 |
| Business Phone Number: | 4109711102 |
| Business Fax Number: | 4102032258 |
| Mailing Address: | 10269 Bristol Channel, ELLICOTT CITY |
| State: | MD |
| Postal Code: | 210425820 |
| Phone Number: | 4109711102 |
| Fax Number: | 4102032258 |
| NPI Enumeration Date: | 04/19/2016 |
| NPI Last Update Date: | 04/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 012109-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |