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General NPI Number Information
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NPI Number | 1720499296
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Entity Type | Individual
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Provider Name | TONYA ATWOOD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2014
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Last Update Date | 05/18/2014
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Provider Practice Location Address
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Address Line | 315 GROVE ST
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City | HUDSON
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State | MI
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Zip | 49247-1213
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Country | US
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Telephone | 517-398-0287
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Fax | 517-306-6016
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Provider Business Mailing Address
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Address Line | 315 GROVE ST
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City | HUDSON
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State | MI
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Zip | 49247-1213
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Country | US
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Telephone | 517-398-0287
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Fax | 517-306-6016
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 230015341500311
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | G5T2D5K7
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | D8N9M3X2
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | Z4B4W6D2
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License Number State | MI
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