Healthcare Provider Details

I. General information

NPI: 1013841634
Provider Name (Legal Business Name): TAMAKIA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14830 N BLACK CANYON HWY APT 1116
PHOENIX AZ
85053-4940
US

IV. Provider business mailing address

1811 HIGHTOWER DR
COLUMBUS OH
43235-5980
US

V. Phone/Fax

Practice location:
  • Phone: 602-880-3983
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: