Provider Demographics
NPI:1689487696
Name:GUIA ESTRADA, TANIA
Entity type:Individual
Prefix:MS
First Name:TANIA
Middle Name:
Last Name:GUIA ESTRADA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4177 MILNER CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8150
Mailing Address - Country:US
Mailing Address - Phone:972-674-6768
Mailing Address - Fax:
Practice Address - Street 1:4177 MILNER CIR APT 103
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8150
Practice Address - Country:US
Practice Address - Phone:972-674-6768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician