Provider Demographics
NPI:1285825000
Name:NATION, TINA K (MS)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:K
Last Name:NATION
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 E MATTERHORN DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-2237
Mailing Address - Country:US
Mailing Address - Phone:928-526-1375
Mailing Address - Fax:
Practice Address - Street 1:3240 E MATTERHORN DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-2237
Practice Address - Country:US
Practice Address - Phone:928-526-1375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist