Provider Demographics
NPI:1114249521
Name:BOOTS, TONYA ELAINE (MS LPC-S, RPT-S)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:ELAINE
Last Name:BOOTS
Suffix:
Gender:F
Credentials:MS LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-1529
Mailing Address - Country:US
Mailing Address - Phone:580-483-9722
Mailing Address - Fax:
Practice Address - Street 1:401 W TAMARACK RD
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-1529
Practice Address - Country:US
Practice Address - Phone:580-483-9722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2856101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor