Provider Demographics
NPI:1245010644
Name:LOFERS-TOMLINSON, DEON ANTOINETTE
Entity type:Individual
Prefix:MRS
First Name:DEON
Middle Name:ANTOINETTE
Last Name:LOFERS-TOMLINSON
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 1:11821 QUEENS BLVD STE 612
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7206
Mailing Address - Country:US
Mailing Address - Phone:929-372-7188
Mailing Address - Fax:
Practice Address - Street 1:11821 QUEENS BLVD STE 602
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7206
Practice Address - Country:US
Practice Address - Phone:929-372-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90405101Y00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor