Provider Demographics
NPI:1669978771
Name:TANGUAY, NICOLE CHRISTINE (MS, CPC-I)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:TANGUAY
Suffix:
Gender:F
Credentials:MS, CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 E WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3185
Mailing Address - Country:US
Mailing Address - Phone:702-434-7290
Mailing Address - Fax:
Practice Address - Street 1:3243 E WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3185
Practice Address - Country:US
Practice Address - Phone:702-434-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC15303101YP2500X
1220764246171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171400000XOther Service ProvidersHealth & Wellness Coach