Provider Demographics
NPI:1841591583
Name:TITSWORTH, TONYA DENISE
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:DENISE
Last Name:TITSWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 HUNTERS RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7829
Mailing Address - Country:US
Mailing Address - Phone:702-516-2864
Mailing Address - Fax:
Practice Address - Street 1:814 HUNTERS RIDGE WAY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7829
Practice Address - Country:US
Practice Address - Phone:702-516-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health