Basic Information
| Provider Information | |||||||||
| NPI: | 1235149444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUNOD | ||||||||
| FirstName: | TONYA | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 829 MACON AVE | ||||||||
| Address2: | |||||||||
| City: | CANON CITY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 812123315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702345358 | ||||||||
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| Practice Location | |||||||||
| Address1: | 691 E EMPIRE ST | ||||||||
| Address2: | |||||||||
| City: | CORTEZ | ||||||||
| State: | CO | ||||||||
| PostalCode: | 813212802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9705657946 | ||||||||
| FaxNumber: | 9705659005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 08/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 431 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.