MEDICARE: MRS. TONYA AURORA ALEXANDER BUTLER LPC

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	101Y00000X	Counselor	98497	TX
2	101YP2500X	Professional Counselor	17360	TX

General Provider Information

NPI Number	:	1598067837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONYA AURORA ALEXANDER BUTLER LPC

Provider Business Mailing Address
First Line	:	6116 N CENTRAL EXPY
Second Line	:	120
City	:	DALLAS
State	:	TX
Zip	:	75206-5162
Country	:	US
Telephone Number	:	903-449-9036
Fax Number	:	903-587-3101

Provider Business Practice Location Address
First Line	:	6116 N CENTRAL EXPY
Second Line	:	120
City	:	DALLAS
State	:	TX
Zip	:	75206-5162
Country	:	US
Telephone Number	:	903-449-9036
Fax Number	:	903-587-3101

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

Provider Enumeration Date	:	11/18/2010
Last Update Date	:	11/18/2010

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