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General NPI Number Information
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NPI Number | 1669978771
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Entity Type | Individual
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Provider Name | NICOLE CHRISTINE TANGUAY MS, CPC-I, LAC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2125 E DESOTO WAY
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City | GILBERT
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State | AZ
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Zip | 85234-3833
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Country | US
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Telephone | 702-913-3625
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Fax |
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Provider Business Mailing Address
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Address Line | 2125 E DESOTO WAY
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City | GILBERT
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State | AZ
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Zip | 85234-3833
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Country | US
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Telephone | 702-913-3625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CI5303
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LAC-23170
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License Number State | AZ
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