Provider Demographics
NPI:1801679071
Name:DELL, TANIA MONE'
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:MONE'
Last Name:DELL
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 1:1400 KIRK FARM LN APT 104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4032
Mailing Address - Country:US
Mailing Address - Phone:313-805-9980
Mailing Address - Fax:
Practice Address - Street 1:11020 DAVID TAYLOR DR STE 326
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1103
Practice Address - Country:US
Practice Address - Phone:980-433-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical