=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063237055
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TANYA BROWN-DAVIS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2024
-----------------------------------------------------
Last Update Date | 11/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 N FANNIN AVE
-----------------------------------------------------
City | DENISON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75020-3118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-525-2498
-----------------------------------------------------
Fax | 469-277-1934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 211
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75091-0211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-525-2498
-----------------------------------------------------
Fax | 469-277-1934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | TANYA LANETTE TANYA BROWN-DAVI
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 469-525-2498
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------