Provider Demographics
NPI:1548589336
Name:TENAGLIO, KAREN COLLEEN (LMT / LE)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:COLLEEN
Last Name:TENAGLIO
Suffix:
Gender:F
Credentials:LMT / LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 CASAZZA DR
Mailing Address - Street 2:SUITE / E BOX 10
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9304
Mailing Address - Country:US
Mailing Address - Phone:775-337-2525
Mailing Address - Fax:
Practice Address - Street 1:507 CASAZZA DR
Practice Address - Street 2:SUITE / E
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-9304
Practice Address - Country:US
Practice Address - Phone:775-337-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT1534225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist