Provider Demographics
NPI:1891942892
Name:MOORE, TANIA KAY
Entity Type:Individual
Prefix:MRS
First Name:TANIA
Middle Name:KAY
Last Name:MOORE
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 1:10379 W WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-5531
Mailing Address - Country:US
Mailing Address - Phone:303-979-0980
Mailing Address - Fax:303-987-9244
Practice Address - Street 1:10379 W WALKER AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5531
Practice Address - Country:US
Practice Address - Phone:303-979-0980
Practice Address - Fax:303-987-9244
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0342232231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist