Provider Demographics
NPI:1033852637
Name:ZELIK, TONIA LEA
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:LEA
Last Name:ZELIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:LEA
Other - Last Name:ZELIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TONIA LEWIS
Mailing Address - Street 1:708 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-3704
Mailing Address - Country:US
Mailing Address - Phone:352-228-4969
Mailing Address - Fax:352-228-8901
Practice Address - Street 1:708 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-3704
Practice Address - Country:US
Practice Address - Phone:352-228-4969
Practice Address - Fax:352-228-8901
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL800768212Medicaid