Provider Demographics
NPI:1831293471
Name:SEALS, TONJALA R (LMSW)
Entity Type:Individual
Prefix:
First Name:TONJALA
Middle Name:R
Last Name:SEALS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 CITY PARK CENTRAL LN
Mailing Address - Street 2:APT 225
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-3242
Mailing Address - Country:US
Mailing Address - Phone:713-791-1414
Mailing Address - Fax:713-794-7352
Practice Address - Street 1:11800 CITY PARK CENTRAL LN
Practice Address - Street 2:APT 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3242
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:713-794-7352
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33121OtherSOCIAL WORK LICENSE