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Individual
TONYA VANDER
Active
Individual
TONYA VANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150.103788
IL
1041C0700X
Clinical Social Worker
Primary
149.023013
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275005670
PSYCHEALTH SERVICES
IL
Enumeration date
01/27/2021
Last updated
06/24/2024
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