Provider Demographics
NPI:1245422971
Name:MURRAY, TONYA SUSAN (MS, SSP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:SUSAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MS, SSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-7427
Mailing Address - Country:US
Mailing Address - Phone:704-455-2213
Mailing Address - Fax:704-455-2246
Practice Address - Street 1:4351 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7427
Practice Address - Country:US
Practice Address - Phone:704-455-2213
Practice Address - Fax:704-455-2246
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2229103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist