Provider Demographics
NPI:1649702275
Name:CULLEY, TONYA LEIGH (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:LEIGH
Last Name:CULLEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 CHERRY HILL DR
Mailing Address - Street 2:SUITE 201-C
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5921
Mailing Address - Country:US
Mailing Address - Phone:573-823-7192
Mailing Address - Fax:
Practice Address - Street 1:2024 CHERRY HILL DR
Practice Address - Street 2:SUITE 201-C
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5921
Practice Address - Country:US
Practice Address - Phone:573-823-7192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035689101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional