Provider Demographics
NPI:1225339104
Name:BATDORFF, TANYA RENE
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:RENE
Last Name:BATDORFF
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 1:834 BUTCH CASSIDY LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9514
Mailing Address - Country:US
Mailing Address - Phone:702-580-4880
Mailing Address - Fax:
Practice Address - Street 1:834 BUTCH CASSIDY LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-9514
Practice Address - Country:US
Practice Address - Phone:702-580-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst