Provider Demographics
NPI:1356830988
Name:TOMICH, MIRIAH (MFT)
Entity type:Individual
Prefix:
First Name:MIRIAH
Middle Name:
Last Name:TOMICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MIRIAH
Other - Middle Name:
Other - Last Name:RUTLEDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 DEHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2711
Mailing Address - Country:US
Mailing Address - Phone:610-209-8496
Mailing Address - Fax:
Practice Address - Street 1:983 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1711
Practice Address - Country:US
Practice Address - Phone:610-209-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist