Individual
TONYA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1899 N WESTWOOD BLVD, STE C PMB 262, POPLAR BLUFF, MO 63901-2833
(573) 772-7937
(573) 778-1315
Mailing address
1369 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3313
(573) 772-7937
(573) 778-1315
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8852
MO
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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