Amos, Tanya M
Amos, Tanya M is an individual health care provider with primary practice located at 230 W Park Street , Wautoma WI 54982-9031. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Amos, Tanya M can be contacted via phone (920) 787-6550.Contact Information
Primary practice address
230 W Park Street
Wautoma WI 54982-9031
Phone: (920) 787-6550
Fax: (920) 787-0421
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 4648-125 | Wisconsin |
Profile Details
| NPI number | 1265714455 |
|---|---|
| LBN Legal business name | Amos, Tanya M |
| Credentials | MS, LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2011 |
| Last updated | Jan 16th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265714455 | NPPES |
| Wisconsin | MEDICAID | 1265714455 |
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