Provider Demographics
NPI:1801261805
Name:TONON, ALYSE L (CMHC)
Entity type:Individual
Prefix:MISS
First Name:ALYSE
Middle Name:L
Last Name:TONON
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 521207
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84152-1207
Mailing Address - Country:US
Mailing Address - Phone:801-983-5540
Mailing Address - Fax:801-983-5542
Practice Address - Street 1:3195 S MAIN ST STE 180
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-3790
Practice Address - Country:US
Practice Address - Phone:801-983-5540
Practice Address - Fax:801-983-5542
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10925432-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health