Provider Demographics
NPI:1558178145
Name:REDDY, TONYA KAY
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:KAY
Last Name:REDDY
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 1:665 WOODVILLE RD REAR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1740
Mailing Address - Country:US
Mailing Address - Phone:567-506-7150
Mailing Address - Fax:
Practice Address - Street 1:665 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1740
Practice Address - Country:US
Practice Address - Phone:567-560-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health