Provider Demographics
NPI:1922805563
Name:HARRIMAN, TOBY MAE
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:MAE
Last Name:HARRIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILLY
Other - Middle Name:MAE
Other - Last Name:HARRIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4583
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 WARREN ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4583
Practice Address - Country:US
Practice Address - Phone:111-111-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician