Tenna Dawn Hazen

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12045045 Issued in MO

Practice address

122 E Lieber St
Maryville, MO 64468-2617

Phone

(660) 582-7113

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 17, 2020.

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1164025839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E LIEBER ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682617",
            "telephone_number": "660-582-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E LIEBER ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682617",
            "telephone_number": "660-582-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "TENNA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "12045045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adon Harris, MD
• Markham Jay Harris, D.D.S
• Shirley Denise Harris, MD
• Kanti L. Havaldar, M.D.
• Leslie L Hawk, R.D., L.D.
• Marah Elizabeth Heckman, PHARMD
• Sara Beth Henggeler, FNP-C
• Jillian Henry
• Jennifer A. Herndon, OT
• Elizabeth Hevern, ATC

• All providers in Maryville, MO
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.