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Provider Information for 1518165562


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Dr. TONYA N/A PLEASANT LCPC, CRC, NCC, CCFC


Sex: Female

NPI: 1518165562
Last Updated: 2007-07-10
Certification Date:

Details

NameValue
NPI1518165562
Enumeration Date2007-07-10
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address PO BOX 983
LANHAM, MD 20703-0983
United States

Phone: 301-352-8482 | Fax:
 
Primary Practice Address 9841 GREENBELT RD
SUITE 208
LANHAM, MD 20706-6269
United States

Phone: 301-352-8482 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMD010775100
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalMDLC1574