Provider Demographics
NPI:1639257231
Name:BYERS, TONI RAE (CDP)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:RAE
Last Name:BYERS
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:MRS
Other - First Name:TONI
Other - Middle Name:RAE
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CDP
Mailing Address - Street 1:3312 1ST ST
Mailing Address - Street 2:
Mailing Address - City:UNION GAP
Mailing Address - State:WA
Mailing Address - Zip Code:98903-1821
Mailing Address - Country:US
Mailing Address - Phone:509-965-3115
Mailing Address - Fax:509-966-5371
Practice Address - Street 1:1015 SOUTH 40TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908
Practice Address - Country:US
Practice Address - Phone:509-965-3115
Practice Address - Fax:509-966-5371
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00005109101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)