Provider Demographics
NPI:1871729087
Name:HAIL, TONI M (LCSW)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:M
Last Name:HAIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74465-0163
Mailing Address - Country:US
Mailing Address - Phone:918-207-7518
Mailing Address - Fax:
Practice Address - Street 1:310 W KEETOOWAH ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3824
Practice Address - Country:US
Practice Address - Phone:918-708-9558
Practice Address - Fax:918-708-9580
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical