Individual
MRS. TONYA RENEE TAYLOR-BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CSAC, QMHP
Contact information
Practice address
210 N BROAD ST, SUFFOLK, VA 23434-5606
(757) 923-1379
Mailing address
210 N BROAD ST, SUFFOLK, VA 23434-5606
(757) 735-9252
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102607
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0710102607
—
VA
Enumeration date
01/08/2010
Last updated
01/08/2010
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