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NPI Code Detail

MEDICARE: TIKEISHA DANIELLE PENDLETON LMSW

MEDICARE:   TIKEISHA DANIELLE PENDLETON  LMSW
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
1104100000XSocial WorkerLMSW-13818AZ

General Provider Information

NPI Number : 1306273388
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIKEISHA DANIELLE PENDLETON LMSW
Provider Business Mailing Address
First Line : 1283 MURFREESBORO PIKE STE 500
Second Line :
City : NASHVILLE
State : TN
Zip : 37217-2421
Country : US
Telephone Number : 800-592-2974
Fax Number :
Provider Business Practice Location Address
First Line : 1270 W SILVERLAKE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85713-2728
Country : US
Telephone Number : 520-351-8104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2013
Last Update Date : 01/08/2015

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Directions to “ TIKEISHA DANIELLE PENDLETON LMSW” Practice Location

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