Provider Demographics
NPI:1093174203
Name:LANGLEY, TONYA RENEHA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:RENEHA
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 PATTON LN
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8618
Mailing Address - Country:US
Mailing Address - Phone:865-354-3941
Mailing Address - Fax:
Practice Address - Street 1:257 PATTON LN
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8618
Practice Address - Country:US
Practice Address - Phone:865-354-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1724224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant