Doctor Name: | TANYA BATES |
NPI Number: | 1437376928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.A./CASAC-T/NYSCNA |
License Number: | |
Business Practice Address: | 15 S 27th St Wyandanch, NY - 117983705 |
Business Phone Number: | 3476508233 |
Business Fax Number: | |
Mailing Address: | 15 South 27th Street, WYANDANCH |
State: | NY |
Postal Code: | 117990000 |
Phone Number: | 3347650823 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 09/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |