Toni Willis, MA-CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Springfield, MI
NPI 1013507367 · NPPES record last updated Jan 21, 2021
Key facts
- NPI
- 1013507367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 777 Goguac St W Ste B2
Springfield, MI 49015-2097 - Phone
- (269) 223-7786
- NPI assigned
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
777 Goguac St W Ste B2
Springfield, MI 49015-2097
Mailing address
777 Goguac St W Ste B2
Springfield, MI 49015-2097
Phone (269) 223-7786
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000 | Medicaid | MI |
Other names
- Miss Toni Medure
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | SPRINGFIELD | Functional Kids Therapy Center LLC | |
| CONNECT URL | SPRINGFIELD | Direct | FUNctional Kids Therapy Center LLC |
Other providers in Springfield, MI
- Nicholas James Vandemoortel
- Vanwinkle Family Chiropractic PLC
- Jennifer Lynn Vanwinkle
- Breonna Warren
- William Francis Waterbury II
All providers in Springfield, MI · Speech-Language Pathologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.