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Individual

ANNA TARNOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
102 N CORONADO AVE, ESPANOLA, NM 87532-2700
(505) 629-1813
(505) 753-6947
Mailing address
102 N CORONADO AVE, ESPANOLA, NM 87532-2700
(505) 629-1813
(505) 753-6947

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T-0181321
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35588519
NM
Enumeration date
05/24/2016
Last updated
05/24/2016
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