Provider Demographics
NPI:1457554719
Name:PRYCE, TANIA RAE (MS)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:RAE
Last Name:PRYCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:RAE
Other - Last Name:PRYCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:3934 S 214TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-1927
Mailing Address - Country:US
Mailing Address - Phone:918-832-7763
Mailing Address - Fax:918-392-0194
Practice Address - Street 1:3934 S 214TH EAST AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-1927
Practice Address - Country:US
Practice Address - Phone:918-832-7763
Practice Address - Fax:918-392-0194
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor