Provider Demographics
NPI:1104523075
Name:DELANEY, TONYA
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:DELANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 TURNBERRY PL
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30656-3381
Mailing Address - Country:US
Mailing Address - Phone:770-280-7292
Mailing Address - Fax:
Practice Address - Street 1:745 S MILLEDGE AVE STE 1A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1292
Practice Address - Country:US
Practice Address - Phone:706-498-9560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0084511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical