Provider Demographics
NPI:1427390947
Name:CARNES-QUIVER, TONYA J (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:J
Last Name:CARNES-QUIVER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:J
Other - Last Name:CARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:PO BOX 2254
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-2254
Mailing Address - Country:US
Mailing Address - Phone:405-320-1830
Mailing Address - Fax:
Practice Address - Street 1:1400 S MISSION ST
Practice Address - Street 2:
Practice Address - City:ANADARKO
Practice Address - State:OK
Practice Address - Zip Code:73005-5813
Practice Address - Country:US
Practice Address - Phone:405-247-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108245235Z00000X
OK4088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist