Doctor Name: | TONI S. WASSON |
NPI Number: | 1710119326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS/LCPC/LPC |
License Number: | 2748-125 |
Business Practice Address: | 14251 Laube Rd Durand, IL - 610249651 |
Business Phone Number: | 8159735153 |
Business Fax Number: | |
Mailing Address: | 14251 Laube Rd, DURAND |
State: | IL |
Postal Code: | 610249651 |
Phone Number: | 8159735153 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2009 |
NPI Last Update Date: | 08/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2748-125 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |