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General NPI Number Information
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NPI Number | 1760095616
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Entity Type | Individual
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Provider Name | SIDNEY TONKIN LLMSW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 5943 STADIUM DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-3016
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Country | US
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Telephone | 269-389-9102
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Fax |
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Provider Business Mailing Address
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Address Line | 47 FULLER AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-3642
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Country | US
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Telephone | 720-544-3947
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851119679
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License Number State | MI
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