Provider Demographics
NPI:1629461850
Name:HILL, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HILL
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 1:4650 RANCH HOUSE RD
Mailing Address - Street 2:UNIT #125
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4606
Mailing Address - Country:US
Mailing Address - Phone:702-332-9935
Mailing Address - Fax:
Practice Address - Street 1:4650 RANCH HOUSE RD
Practice Address - Street 2:UNIT #125
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4606
Practice Address - Country:US
Practice Address - Phone:702-332-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst