Provider Demographics
NPI:1669247680
Name:CLAUDIO, TAISHA MONIQUE
Entity type:Individual
Prefix:
First Name:TAISHA
Middle Name:MONIQUE
Last Name:CLAUDIO
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 1:231 TENNESSEE ST NE APT C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2385
Mailing Address - Country:US
Mailing Address - Phone:505-720-4783
Mailing Address - Fax:
Practice Address - Street 1:231 TENNESSEE ST NE APT C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2385
Practice Address - Country:US
Practice Address - Phone:505-720-4783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician