Provider Demographics
NPI:1447780630
Name:TEJEDA, TANIA LIBERTAD (RBT)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:LIBERTAD
Last Name:TEJEDA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 W 20TH AVE APT 415
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7560
Mailing Address - Country:US
Mailing Address - Phone:786-759-3688
Mailing Address - Fax:
Practice Address - Street 1:5851 W 20TH AVE APT 415
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7560
Practice Address - Country:US
Practice Address - Phone:786-759-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician