| Doctor Name: | TANYA MALLAN |
| NPI Number: | 1336467919 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | TANYA MALLAN |
| License Number: | 10037 |
| Business Practice Address: | 5289 Joaquin Rd Santa Rosa, CA - 954092843 |
| Business Phone Number: | 7074770434 |
| Business Fax Number: | |
| Mailing Address: | 5289 Joaquin Rd, SANTA ROSA |
| State: | CA |
| Postal Code: | 954092843 |
| Phone Number: | 7075388092 |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2010 |
| NPI Last Update Date: | 05/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 10037 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |