Provider Demographics
NPI:1023689908
Name:TONER, KAMERON R (RBT)
Entity type:Individual
Prefix:MR
First Name:KAMERON
Middle Name:R
Last Name:TONER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 W RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48657-9437
Mailing Address - Country:US
Mailing Address - Phone:989-941-9101
Mailing Address - Fax:
Practice Address - Street 1:523 W RIDGE DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:MI
Practice Address - Zip Code:48657-9437
Practice Address - Country:US
Practice Address - Phone:989-941-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician