Healthcare Provider Details

I. General information

NPI: 1811662729
Provider Name (Legal Business Name): TANIAH ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 COX RD
GASTONIA NC
28054-3496
US

IV. Provider business mailing address

941 PROFESSIONAL PARK DR
CLARKSVILLE TN
37040-5137
US

V. Phone/Fax

Practice location:
  • Phone: 704-780-4271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: