Provider Demographics
NPI:1730663345
Name:HERSCHAP, TANCY ADAMS
Entity type:Individual
Prefix:
First Name:TANCY
Middle Name:ADAMS
Last Name:HERSCHAP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 642
Mailing Address - Street 2:
Mailing Address - City:ORANGE GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:78372-0642
Mailing Address - Country:US
Mailing Address - Phone:361-290-0679
Mailing Address - Fax:361-661-0746
Practice Address - Street 1:219 N KING ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4841
Practice Address - Country:US
Practice Address - Phone:361-661-0748
Practice Address - Fax:361-661-0746
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101263235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty