Provider Demographics
NPI:1528303625
Name:HARDEMAN, TASHA NASHA
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:NASHA
Last Name:HARDEMAN
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 1:3108 CHADFORD PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7830
Mailing Address - Country:US
Mailing Address - Phone:702-517-9257
Mailing Address - Fax:
Practice Address - Street 1:6655 W SAHARA AVE
Practice Address - Street 2:A-110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0842
Practice Address - Country:US
Practice Address - Phone:702-365-0600
Practice Address - Fax:702-365-0602
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor