Provider Demographics
NPI:1063707024
Name:DRUMMOND, TANISHA E (PSYD)
Entity type:Individual
Prefix:DR
First Name:TANISHA
Middle Name:E
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613C HARFORD RD # 202
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2103
Mailing Address - Country:US
Mailing Address - Phone:410-417-7474
Mailing Address - Fax:443-546-9887
Practice Address - Street 1:1965 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4137
Practice Address - Country:US
Practice Address - Phone:443-631-8417
Practice Address - Fax:443-546-9887
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05127103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist