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Individual

TANYA GEANNA MACLEOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
474 WEST VERMONT AVE., STE., 101, ESCONDIDO, CA 92025
(760) 480-2255
(760) 888-8339
Mailing address
474 WEST VERMONT AVE. STE,. 101, ESCONDIDO, CA 92025
(760) 480-2255
(760) 888-8339

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-SLPGXB
CA
175T00000X
Peer Specialist

Other

Enumeration date
10/19/2020
Last updated
11/01/2023
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