Provider Demographics
NPI:1154651818
Name:HILLMAN, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 N CASTRO AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-5060
Mailing Address - Country:US
Mailing Address - Phone:520-622-8030
Mailing Address - Fax:520-622-8012
Practice Address - Street 1:2435 N CASTRO AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-5060
Practice Address - Country:US
Practice Address - Phone:520-622-8030
Practice Address - Fax:520-622-8012
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC14430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional