Provider Demographics
NPI:1316275324
Name:TOENJES, ALLISON DIANE
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:DIANE
Last Name:TOENJES
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 1:118 WESTHAVEN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-3264
Mailing Address - Country:US
Mailing Address - Phone:618-257-9201
Mailing Address - Fax:
Practice Address - Street 1:1433 DOLMAN ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-3307
Practice Address - Country:US
Practice Address - Phone:314-494-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.002078224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant