Provider Demographics
NPI:1174349856
Name:BHARDWAJ, TANYA
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:BHARDWAJ
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 1:14191 MONTEREY PINES DR # 35
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6485
Mailing Address - Country:US
Mailing Address - Phone:813-894-4854
Mailing Address - Fax:
Practice Address - Street 1:40351 US HIGHWAY 19 N STE 317
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4858
Practice Address - Country:US
Practice Address - Phone:727-330-8932
Practice Address - Fax:727-350-1055
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician