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General NPI Number Information
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NPI Number | 1710876412
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Entity Type | Individual
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Provider Name | TANYA CALLARD LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 07/06/2025
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Provider Practice Location Address
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Address Line | 911 W CENTER ST
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City | MEDINA
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State | NY
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Zip | 14103-1039
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Country | US
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Telephone | 585-637-3905
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Fax |
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Provider Business Mailing Address
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Address Line | 162 N MAIN ST
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City | LYNDONVILLE
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State | NY
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Zip | 14098-9673
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Country | US
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Telephone | 213-422-7002
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 127814
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License Number State | NY
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