Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 0873 | KY |
N | 103TC0700X | Clinical Psychologist | 0873 | KY |
N | 103TH0100X | Health Service |
NPI | 1457572323 |
---|---|
Provider Name | Dr. Mark Anthony Toennis |
First Address | Fort Thomas, KY 41075-1800 |
Second Address | Cold Spring, KY 41076-3501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000001623 | ANTHEM (01) | KY |
00005490061 | AETNA (01) | KY |
10654346857 | HUMANA (01) | KY |