Provider Demographics
NPI:1053023614
Name:TOROK, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TOROK
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 1:284 E JEFFREY PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1706
Mailing Address - Country:US
Mailing Address - Phone:513-917-7149
Mailing Address - Fax:
Practice Address - Street 1:284 E JEFFREY PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1706
Practice Address - Country:US
Practice Address - Phone:513-917-7149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHBACB784854106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician