Provider Demographics
NPI:1477290435
Name:HARLAN, TONYA MARIE (NBC-HWC)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:MARIE
Last Name:HARLAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 W SINCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:WEST BADEN SPRINGS
Mailing Address - State:IN
Mailing Address - Zip Code:47469-9682
Mailing Address - Country:US
Mailing Address - Phone:812-572-9461
Mailing Address - Fax:
Practice Address - Street 1:7230 ARBUCKLE CMNS
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1791
Practice Address - Country:US
Practice Address - Phone:812-572-9461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INA-3270422171400000X
IN88001930A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach