Hagan, Tari Lynn
Hagan, Tari Lynn is an individual health care provider with primary practice located at 1331 Gusdorf Road , Taos NM 87571. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hagan, Tari Lynn can be contacted via phone (505) 758-9412.Contact Information
Primary practice address
1331 Gusdorf Road
Taos NM 87571
Phone: (505) 758-9412
Fax: (505) 751-4688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I3935 | New Mexico |
Profile Details
| NPI number | 1770615106 |
|---|---|
| LBN Legal business name | Hagan, Tari Lynn |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1770615106 | NPPES |
| New Mexico | MEDICAID | 76377717 |
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