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Tanya Sue Smith

Counselor, Professional in Modesto, CA. Individual provider (NPI-1).

NPI number1760104558
StatusActive
Last updated in NPPESFeb 4, 2025

Details

NPI
1760104558
Entity type
Individual (NPI-1)
Name
Tanya Sue Smith
Sex
Female
Sole proprietor
No
Enumeration date
Sep 19, 2022
Certification date
Feb 4, 2025
Last updated
Feb 4, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, ProfessionalAPCC11511CAYes

Practice location

121 Downey Ave
Modesto, CA 95354-1208

Phone 209-341-1824

Mailing address

Po Box 1112
Salida, CA 95368-1112

Phone 209-610-4787

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