Doctor Name: | TINA DAWN HALLAUER |
NPI Number: | 1205811064 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | MH7530 |
Business Practice Address: | 3501 W Vine St Suite 266 Kissimmee, FL - 347414643 |
Business Phone Number: | 4078464111 |
Business Fax Number: | 4078468088 |
Mailing Address: | 3501 W Vine St, Suite 266 KISSIMMEE |
State: | FL |
Postal Code: | 347414643 |
Phone Number: | 4078464111 |
Fax Number: | 4078468088 |
NPI Enumeration Date: | 12/14/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MH7530 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |