Provider Demographics
NPI:1902027758
Name:ALLEN, TONYA DEEANNE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:DEEANNE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020
Mailing Address - Country:US
Mailing Address - Phone:405-769-7070
Mailing Address - Fax:405-769-7070
Practice Address - Street 1:5350 S WESTERN STE 555
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109
Practice Address - Country:US
Practice Address - Phone:405-631-4567
Practice Address - Fax:405-631-4593
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional