Provider Demographics
NPI:1053652537
Name:GIRARD, TONYA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 WINTON RD S
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1633
Mailing Address - Country:US
Mailing Address - Phone:585-563-5635
Mailing Address - Fax:
Practice Address - Street 1:490 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1229
Practice Address - Country:US
Practice Address - Phone:585-922-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist