| Doctor Name: | MS. TONYA RENEE SHORTER |
| NPI Number: | 1205253499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1009 Homesite Ave Lindenwold, NJ - 080213529 |
| Business Phone Number: | 8566558012 |
| Business Fax Number: | 8562257650 |
| Mailing Address: | 1009 Homesite Ave, LINDENWOLD |
| State: | NJ |
| Postal Code: | 080213529 |
| Phone Number: | 8566558012 |
| Fax Number: | 8562257650 |
| NPI Enumeration Date: | 03/25/2014 |
| NPI Last Update Date: | 03/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |