MEDICARE: TANYA DAWN HAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	11938	CO

General Provider Information

NPI Number	:	1609193457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA DAWN HAND

Provider Business Mailing Address
First Line	:	19 DARTMOUTH AVE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81005-1755
Country	:	US
Telephone Number	:	719-302-2703
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 CLUB MANOR DR
Second Line	:	SUITE 100
City	:	PUEBLO
State	:	CO
Zip	:	81008-1679
Country	:	US
Telephone Number	:	719-584-4671
Fax Number	:	719-584-4759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	05/03/2010

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Directions to “ TANYA DAWN HAND ” Practice Location

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