Provider Demographics
NPI:1134778194
Name:TINSLEY, ROYLETTA (MHC, MFT)
Entity type:Individual
Prefix:
First Name:ROYLETTA
Middle Name:
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:MHC, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 NW 21ST CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3218
Mailing Address - Country:US
Mailing Address - Phone:954-696-1718
Mailing Address - Fax:
Practice Address - Street 1:8921 NW 21ST CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3218
Practice Address - Country:US
Practice Address - Phone:954-696-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty