Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 103K00000X | Behavior Analyst | ||
N | 104100000X | Social Worker |
NPI | 1003366113 |
---|---|
Provider Name | Tanya Tobing |
First Address | Colton, CA 92324-6321 |
Second Address | Upland, CA 91786-8007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2016 |
Last Update Date | 11/03/2020 |