Provider Demographics
NPI:1114302726
Name:EVANS, TONYA KAY (MS)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:KAY
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:TONYA
Other - Middle Name:KAY
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1500 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-3304
Mailing Address - Country:US
Mailing Address - Phone:304-860-6652
Mailing Address - Fax:
Practice Address - Street 1:1500 ROUND HILL RD
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3304
Practice Address - Country:US
Practice Address - Phone:304-860-6652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1109103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist