Provider Demographics
NPI:1356172241
Name:DELAHOUSSAYE, TANNA SHANICE
Entity type:Individual
Prefix:
First Name:TANNA
Middle Name:SHANICE
Last Name:DELAHOUSSAYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TANNA
Other - Middle Name:SHANICE
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2950 CULLEN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3922
Mailing Address - Country:US
Mailing Address - Phone:346-440-4067
Mailing Address - Fax:281-456-3294
Practice Address - Street 1:2950 CULLEN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3922
Practice Address - Country:US
Practice Address - Phone:346-440-4067
Practice Address - Fax:281-456-3294
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician