Provider Demographics
NPI:1386311892
Name:HERNANDEZ, TANYA G
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:G
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 TRAVIS ST STE 111
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3965
Mailing Address - Country:US
Mailing Address - Phone:913-736-3348
Mailing Address - Fax:
Practice Address - Street 1:8220 TRAVIS ST STE 111
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3965
Practice Address - Country:US
Practice Address - Phone:913-736-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker