Provider Demographics
NPI:1043953763
Name:SANDS, TONI MARIE (LPC)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:SANDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TX
Mailing Address - Zip Code:79830-3029
Mailing Address - Country:US
Mailing Address - Phone:505-480-1480
Mailing Address - Fax:
Practice Address - Street 1:1106 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-3029
Practice Address - Country:US
Practice Address - Phone:505-480-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional