Provider Demographics
NPI:1215275599
Name:COLLINS, TONYA LANETTA
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:LANETTA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:LANETTA
Other - Last Name:FELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 CARRIAGE LN STE 203
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:843-573-1926
Practice Address - Street 1:4 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6065
Practice Address - Country:US
Practice Address - Phone:843-573-1905
Practice Address - Fax:843-573-1926
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health