Provider Demographics
NPI:1265299259
Name:ALSTON, TONYA MARIE
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:MARIE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 HERALDY CT
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-1838
Mailing Address - Country:US
Mailing Address - Phone:919-438-5738
Mailing Address - Fax:
Practice Address - Street 1:134 PARKTOWN RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-9153
Practice Address - Country:US
Practice Address - Phone:919-438-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health