Healthcare Provider Details

I. General information

NPI: 1518501501
Provider Name (Legal Business Name): ASIA TAU-TOLLIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 VALLEY FORGE WAY
SPARKS NV
89431-1170
US

IV. Provider business mailing address

3224 VALLEY FORGE WAY
SPARKS NV
89431-1170
US

V. Phone/Fax

Practice location:
  • Phone: 775-379-2741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: