Provider Demographics
NPI:1386919710
Name:HILLMAN, TONYA ANNETTE (MS, LPC)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:ANNETTE
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24150 SWIFT LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65583-3340
Mailing Address - Country:US
Mailing Address - Phone:573-433-0587
Mailing Address - Fax:
Practice Address - Street 1:23526 RESTORE
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-3215
Practice Address - Country:US
Practice Address - Phone:573-855-9114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012007128101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional