Provider Demographics
NPI:1063380186
Name:WOOD, TONJA ANNETTE (BSW, CPSS, CFSP)
Entity type:Individual
Prefix:MRS
First Name:TONJA
Middle Name:ANNETTE
Last Name:WOOD
Suffix:
Gender:F
Credentials:BSW, CPSS, CFSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 E ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-2020
Mailing Address - Country:US
Mailing Address - Phone:208-432-1976
Mailing Address - Fax:208-432-7956
Practice Address - Street 1:675 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-2020
Practice Address - Country:US
Practice Address - Phone:208-432-1976
Practice Address - Fax:208-432-7956
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID175T00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist