Provider Demographics
NPI:1669785267
Name:TONYA JAMES
Entity type:Organization
Organization Name:TONYA JAMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:CHEIRE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS OF ARTS
Authorized Official - Phone:580-369-2859
Mailing Address - Street 1:500 SS ST APT 38
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:OK
Mailing Address - Zip Code:73030-2244
Mailing Address - Country:US
Mailing Address - Phone:580-369-2859
Mailing Address - Fax:
Practice Address - Street 1:500 SS ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:OK
Practice Address - Zip Code:73030-2200
Practice Address - Country:US
Practice Address - Phone:580-369-2859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH2A3M4B7Medicaid