Individual
TONYA MARIE MARAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSS
Contact information
Practice address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 319-9899
Mailing address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 319-9899
(270) 305-3253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
275316
KY
1041C0700X
Clinical Social Worker
Primary
TC00001083
KY
175T00000X
Peer Specialist
1170044
KY
Other
Enumeration date
03/27/2020
Last updated
07/25/2026
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