Provider Demographics
NPI:1932417656
Name:TOLES, MARYANN (LPC)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:TOLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18350 NW 2ND AVE
Mailing Address - Street 2:SUITE 324
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4519
Mailing Address - Country:US
Mailing Address - Phone:305-770-4565
Mailing Address - Fax:305-770-4566
Practice Address - Street 1:18350 NW 2ND AVE
Practice Address - Street 2:SUITE 324
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4519
Practice Address - Country:US
Practice Address - Phone:305-770-4565
Practice Address - Fax:305-770-4566
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional