Provider Demographics
NPI:1538872361
Name:OPTIMUM THERAPY & CONSULTS
Entity type:Organization
Organization Name:OPTIMUM THERAPY & CONSULTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:O
Authorized Official - Last Name:EGHAGHE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:443-454-4802
Mailing Address - Street 1:7201 PAHLS FARM WAY
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5852
Mailing Address - Country:US
Mailing Address - Phone:443-454-4802
Mailing Address - Fax:
Practice Address - Street 1:7201 PAHLS FARM WAY
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5852
Practice Address - Country:US
Practice Address - Phone:443-454-4802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty