Provider Demographics
NPI:1306192299
Name:DEWS, TANISHA YVONNE (BS)
Entity Type:Individual
Prefix:MS
First Name:TANISHA
Middle Name:YVONNE
Last Name:DEWS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NE 46TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-3309
Mailing Address - Country:US
Mailing Address - Phone:405-602-6331
Mailing Address - Fax:405-602-6659
Practice Address - Street 1:401 NE 46TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-3309
Practice Address - Country:US
Practice Address - Phone:405-602-6331
Practice Address - Fax:405-602-6659
Is Sole Proprietor?:No
Enumeration Date:2012-07-28
Last Update Date:2012-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor