Basic Information
| Provider Information | |||||||||
| NPI: | 1821765686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZIEGLER | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | SUZANNE | ||||||||
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| Credential: | CRC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3825 E TOWNLINE LAKE RD | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486258971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087150224 | ||||||||
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| Practice Location | |||||||||
| Address1: | 789 N CLARE AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486258250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895392141 | ||||||||
| FaxNumber: | 9895392143 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2021 | ||||||||
| LastUpdateDate: | 08/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 00113680 | ID | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.