Provider Demographics
NPI:1972750156
Name:TUCKER-SCHOLLA, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:TUCKER-SCHOLLA
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 1:4089 BRANDES ST
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:NY
Mailing Address - Zip Code:14880-9794
Mailing Address - Country:US
Mailing Address - Phone:585-593-5844
Mailing Address - Fax:
Practice Address - Street 1:4089 BRANDES ST
Practice Address - Street 2:
Practice Address - City:SCIO
Practice Address - State:NY
Practice Address - Zip Code:14880-9794
Practice Address - Country:US
Practice Address - Phone:585-593-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011291-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist