Provider Demographics
NPI:1518150432
Name:HIGH, TANYA M (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:M
Last Name:HIGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 VILLAGE PLACE CIR NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012
Mailing Address - Country:US
Mailing Address - Phone:404-324-2132
Mailing Address - Fax:770-679-9083
Practice Address - Street 1:2121 FOUNTAIN DR
Practice Address - Street 2:SUITE E
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7023
Practice Address - Country:US
Practice Address - Phone:404-659-5909
Practice Address - Fax:678-512-0115
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT002297175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath