Provider Demographics
NPI:1457894578
Name:GUZMAN, TANIA R
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:R
Last Name:GUZMAN
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 1:7375 PRAIRIE FALCON RD STE 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0818
Mailing Address - Country:US
Mailing Address - Phone:702-773-9028
Mailing Address - Fax:702-476-1926
Practice Address - Street 1:7375 PRAIRIE FALCON RD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0818
Practice Address - Country:US
Practice Address - Phone:702-773-9028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst