Provider Demographics
NPI:1407732290
Name:WILSON, TONYA RENAE (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:RENAE
Last Name:WILSON
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:MISS
Other - First Name:TONYA
Other - Middle Name:RENAE
Other - Last Name:SAYLOR, GILARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1244 THOMASINA DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-7437
Mailing Address - Country:US
Mailing Address - Phone:386-235-4852
Mailing Address - Fax:
Practice Address - Street 1:841 JIMMY ANN DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4583
Practice Address - Country:US
Practice Address - Phone:386-425-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN110408292084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry