MEDICARE: TARNUE K. G. ALI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1568701688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARNUE K. G. ALI

Provider Business Mailing Address
First Line	:	6013 S REDWOOD RD
Second Line	:
City	:	TAYLORSVILLE
State	:	UT
Zip	:	84123-5220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1870 N MAIN ST
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-7744
Country	:	US
Telephone Number	:	801-255-5131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2013
Last Update Date	:	07/24/2024

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