Provider Demographics
NPI:1598415101
Name:CLAIBORNE, TONI
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:CLAIBORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4130
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-0130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 UNIVERSAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91608-1002
Practice Address - Country:US
Practice Address - Phone:719-650-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-22-200644106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician