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Individual

DR. TONEY LEE CHARLES JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
301 NORTH WELLINGTON ST., MARSHALL, TX 75670-3230
(903) 938-4476
(902) 938-4125
Mailing address
301 N WELLINGTON ST, PO BOX 8317, MARSHALL, TX 75670-3335
(903) 938-4476
(902) 938-4125

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31395
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146705201
TX
01
86649A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/15/2006
Last updated
11/03/2010
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