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General NPI Number Information
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NPI Number | 1629583927
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Entity Type | Individual
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Provider Name | T'ANALISHA MAYO LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 4977 NORTHCUTT PL
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City | DAYTON
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State | OH
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Zip | 45414-3839
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Country | US
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Telephone | 800-829-5461
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Fax |
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Provider Business Mailing Address
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Address Line | 420 60TH ST
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City | VIENNA
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State | WV
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Zip | 26105-8091
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E2102487
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License Number State | OH
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