Provider Demographics
NPI:1477289445
Name:REPA, TONI MARIE (MS, EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:REPA
Suffix:
Gender:F
Credentials:MS, EDS, NCSP
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:MARIE
Other - Last Name:BADURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, EDS, NCSP
Mailing Address - Street 1:29649 MEADOW GATE DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7911
Mailing Address - Country:US
Mailing Address - Phone:717-364-4981
Mailing Address - Fax:
Practice Address - Street 1:29649 MEADOW GATE DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7911
Practice Address - Country:US
Practice Address - Phone:717-364-4981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool