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General NPI Number Information
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NPI Number | 1649530817
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Entity Type | Individual
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Provider Name | MRS. TANYA FAYE NEWTON
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Gender | Female
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 517 OAK ST
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City | ARDMORE
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State | OK
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Zip | 73401-1757
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Country | US
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Telephone | 580-229-3182
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 G ST SW
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City | ARDMORE
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State | OK
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Zip | 73401
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Country | US
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Telephone | 580-465-6684
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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 |
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License Number State |
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