Provider Demographics
NPI:1720757255
Name:MEYERS, TONIA LYNN (MA)
Entity Type:Individual
Prefix:MRS
First Name:TONIA
Middle Name:LYNN
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SARNO RD STE 12
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4993
Mailing Address - Country:US
Mailing Address - Phone:321-914-2126
Mailing Address - Fax:321-306-2879
Practice Address - Street 1:1600 SARNO RD STE 12
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4993
Practice Address - Country:US
Practice Address - Phone:321-622-4066
Practice Address - Fax:321-306-2879
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22799101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional