Healthcare Provider Details

I. General information

NPI: 1700902517
Provider Name (Legal Business Name): TANYA J HALDEN ATC, LAT, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/16/2024
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8392 S CONTINENTAL DIVIDE RD STE 107
LITTLETON CO
80127-4250
US

IV. Provider business mailing address

PO BOX 270673
LITTLETON CO
80127-0011
US

V. Phone/Fax

Practice location:
  • Phone: 720-288-2625
  • Fax:
Mailing address:
  • Phone: 720-252-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: