Provider Demographics
NPI:1952111452
Name:BALADO, TANYA ALEJANDRA
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:ALEJANDRA
Last Name:BALADO
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 1:2245 E HECLA DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2398
Mailing Address - Country:US
Mailing Address - Phone:720-365-9105
Mailing Address - Fax:
Practice Address - Street 1:695 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5969
Practice Address - Country:US
Practice Address - Phone:303-402-9283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter