Healthcare Provider Details

I. General information

NPI: 1477290435
Provider Name (Legal Business Name): TONYA MARIE HARLAN NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 ARBUCKLE CMNS
BROWNSBURG IN
46112-1791
US

IV. Provider business mailing address

7811 W SINCLAIR ST
WEST BADEN SPRINGS IN
47469-9682
US

V. Phone/Fax

Practice location:
  • Phone: 812-572-9461
  • Fax:
Mailing address:
  • Phone: 812-572-9461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3270422
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88001930A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: