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NPI Code Detail

MEDICARE: TONYA ROBERSON

MEDICARE: TONYA ROBERSON
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1891406260
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA ROBERSON
Provider Business Mailing Address
First Line : 4414 SHELBORNE DR
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37416-3314
Country : US
Telephone Number : 718-926-3520
Fax Number :
Provider Business Practice Location Address
First Line : 2514 N BROAD ST # 2
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-4013
Country : US
Telephone Number : 917-691-4219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2022
Last Update Date : 01/15/2026

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Directions to “ TONYA ROBERSON ” Practice Location

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