Individual
DR. TONYA DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPC, LPC, NCC
Contact information
Practice address
101 SOUTHPARK DR, VICKSBURG, MS 39180-9784
(601) 456-1669
Mailing address
101 SOUTHPARK DR, VICKSBURG, MS 39180-9784
(601) 456-1669
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2157
MS
Other
Enumeration date
06/11/2021
Last updated
06/19/2021
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