Provider Demographics
NPI:1295445971
Name:RUFFIN, TONYA HALL (MSW)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:HALL
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:RUFFIN
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1071 SAINT CATHERINE CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-6525
Mailing Address - Country:US
Mailing Address - Phone:912-484-0670
Mailing Address - Fax:
Practice Address - Street 1:500 E OGLETHORPE HWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2804
Practice Address - Country:US
Practice Address - Phone:912-484-0670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW002846104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty