MEDICARE: TONYA MUMM TLMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	113607	IA

General Provider Information

NPI Number	:	1528784584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA MUMM TLMHC

Provider Business Mailing Address
First Line	:	2900 GRANDVIEW BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3749
Country	:	US
Telephone Number	:	166-020-2918
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 5TH ST STE 310
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51101-1508
Country	:	US
Telephone Number	:	712-258-4553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	10/12/2022

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