Provider Demographics
NPI:1154674067
Name:FILES, TANYA NICOLE-BRADFORD (MS)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:NICOLE-BRADFORD
Last Name:FILES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:NICOLE-BRADFORD
Other - Last Name:FILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, BS
Mailing Address - Street 1:301 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:OK
Mailing Address - Zip Code:73541-9432
Mailing Address - Country:US
Mailing Address - Phone:580-483-7584
Mailing Address - Fax:
Practice Address - Street 1:301 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OK
Practice Address - Zip Code:73541-9432
Practice Address - Country:US
Practice Address - Phone:580-483-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst