Provider Demographics
NPI:1386227171
Name:MIHOK, RIVER
Entity type:Individual
Prefix:
First Name:RIVER
Middle Name:
Last Name:MIHOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 W JOPPA RD APT 1E
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4033
Mailing Address - Country:US
Mailing Address - Phone:443-876-9354
Mailing Address - Fax:
Practice Address - Street 1:115 N BROAD ST STE 4A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1045
Practice Address - Country:US
Practice Address - Phone:302-377-6911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0000226104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker