Provider Demographics
NPI:1801162615
Name:DAWSON, TONYA RENE (BCBA)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:RENE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 JAKE SPOON DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-3118
Mailing Address - Country:US
Mailing Address - Phone:254-238-1130
Mailing Address - Fax:
Practice Address - Street 1:4404 JAKE SPOON DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-3118
Practice Address - Country:US
Practice Address - Phone:254-238-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-12-10256103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst