Provider Demographics
NPI:1821780362
Name:MIRSKY, TONIE MICHELE (SUD COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:TONIE
Middle Name:MICHELE
Last Name:MIRSKY
Suffix:
Gender:F
Credentials:SUD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 RANCHEROS DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2900
Mailing Address - Country:US
Mailing Address - Phone:760-744-3672
Mailing Address - Fax:
Practice Address - Street 1:340 RANCHEROS DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2900
Practice Address - Country:US
Practice Address - Phone:760-744-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)