Healthcare Provider Details

I. General information

NPI: 1609172626
Provider Name (Legal Business Name): TANYA APURON LMT, CNMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 E JEFFERSON ST STE E
COLORADO SPRINGS CO
80907-7125
US

IV. Provider business mailing address

1022 E JEFFERSON ST STE E
COLORADO SPRINGS CO
80907-7125
US

V. Phone/Fax

Practice location:
  • Phone: 719-243-5469
  • Fax: 719-570-7718
Mailing address:
  • Phone: 719-243-5469
  • Fax: 719-570-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number10768
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: