| Doctor Name: | MS. TONDA L FORMAN |
| NPI Number: | 1114187655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | 0823 |
| Business Practice Address: | 324 Southview Dr Nicholasville, KY - 403562008 |
| Business Phone Number: | 8592531686 |
| Business Fax Number: | 8592542743 |
| Mailing Address: | 1351 Newtown Pike, LEXINGTON |
| State: | KY |
| Postal Code: | 405111217 |
| Phone Number: | 8592531686 |
| Fax Number: | 8592542743 |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 06/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0823 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |