Provider Demographics
NPI:1174717052
Name:ACKER-RICHARDS, TONJA LEE (MA, LLP)
Entity type:Individual
Prefix:MRS
First Name:TONJA
Middle Name:LEE
Last Name:ACKER-RICHARDS
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866-1326
Mailing Address - Country:US
Mailing Address - Phone:906-475-7856
Mailing Address - Fax:
Practice Address - Street 1:380 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-1326
Practice Address - Country:US
Practice Address - Phone:906-475-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008885103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling