Provider Demographics
NPI:1316834146
Name:HOULIHAN, TARYN
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:HOULIHAN
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 1:8401 SPAIN RD NE APT 45A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2025
Mailing Address - Country:US
Mailing Address - Phone:505-420-2288
Mailing Address - Fax:
Practice Address - Street 1:10401 RESEARCH RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3423
Practice Address - Country:US
Practice Address - Phone:505-823-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker