Provider Demographics
NPI:1891579132
Name:ALSTROM, TONI MARIE MITZI (MS, EDS)
Entity Type:Individual
Prefix:MRS
First Name:TONI MARIE
Middle Name:MITZI
Last Name:ALSTROM
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 STONEWOOD POINTE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-4510
Mailing Address - Country:US
Mailing Address - Phone:785-629-8394
Mailing Address - Fax:
Practice Address - Street 1:743 STONEWOOD POINTE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-4510
Practice Address - Country:US
Practice Address - Phone:785-629-8394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20230007983103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty