Provider Demographics
NPI:1881727097
Name:RIOS, TONITA (PHD, CADC)
Entity type:Individual
Prefix:
First Name:TONITA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:PHD, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 E BLOOMINGTON ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2600
Mailing Address - Country:US
Mailing Address - Phone:319-354-6880
Mailing Address - Fax:
Practice Address - Street 1:626 E BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2600
Practice Address - Country:US
Practice Address - Phone:319-354-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00546103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA232425OtherMIDLAND'S CHOICE