Basic Information
| Provider Information | |||||||||
| NPI: | 1013282342 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANSEN | ||||||||
| FirstName: | TARON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2875 SAINT ROSE PKWY STE 110 | ||||||||
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| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890524842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029660535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3680 N RANCHO DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891303180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028694300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2012 | ||||||||
| LastUpdateDate: | 09/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | NV | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.