Provider Demographics
NPI:1013085562
Name:MILES, TONYA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:L
Last Name:MILES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:L
Other - Last Name:HONEYCUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:11011 KING ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1213
Mailing Address - Country:US
Mailing Address - Phone:913-642-3134
Mailing Address - Fax:888-334-4327
Practice Address - Street 1:11011 KING ST
Practice Address - Street 2:SUITE 290
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1213
Practice Address - Country:US
Practice Address - Phone:913-642-3134
Practice Address - Fax:888-334-4327
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1293103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200297160BMedicaid
KS200297160Medicaid