MEDICARE: TIARA MONET TEMPLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1295443257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIARA MONET TEMPLE

Provider Business Mailing Address
First Line	:	8312 SEATTLE AVE APT 30413
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-1562
Country	:	US
Telephone Number	:	740-815-8733
Fax Number	:

Provider Business Practice Location Address
First Line	:	8312 SEATTLE AVE APT 30413
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-1562
Country	:	US
Telephone Number	:	740-815-8733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	11/18/2022

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Directions to “ TIARA MONET TEMPLE ” Practice Location

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