Provider Demographics
NPI:1831784412
Name:TONEY, MELISSA SUE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:TONEY
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 1:10695 REITZ RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-8976
Mailing Address - Country:US
Mailing Address - Phone:419-304-8012
Mailing Address - Fax:
Practice Address - Street 1:10695 REITZ RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-8976
Practice Address - Country:US
Practice Address - Phone:419-304-8012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 343900000X, 347C00000X, 3747P1801X, 376J00000X
OHRJ594325343900000X, 347C00000X, 374U00000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker