Provider Demographics
NPI:1104426451
Name:WIDMAIER, TONI ANN
Entity type:Individual
Prefix:
First Name:TONI ANN
Middle Name:
Last Name:WIDMAIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 PHEASANT HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3546
Mailing Address - Country:US
Mailing Address - Phone:732-284-8708
Mailing Address - Fax:
Practice Address - Street 1:2311 PHEASANT HOLLOW DR
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3546
Practice Address - Country:US
Practice Address - Phone:732-284-8708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker