Provider Demographics
NPI:1952189235
Name:STEVENS, TONYA RENEAE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:RENEAE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:RENEAE
Other - Last Name:STUNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-1354
Mailing Address - Country:US
Mailing Address - Phone:989-702-2082
Mailing Address - Fax:
Practice Address - Street 1:600 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-1354
Practice Address - Country:US
Practice Address - Phone:989-702-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician