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
175T00000X
Peer Specialist
Primary
1170044
KY
Other
Enumeration date
03/27/2020
Last updated
10/14/2025
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