Healthcare Provider Details
I. General information
NPI: 1295543270
Provider Name (Legal Business Name): TIYETTA JOINER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/23/2024
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7419 HAMILTON AVE
CINCINNATI OH
45231-4305
US
IV. Provider business mailing address
4646 LEADWELL LN
BLUE ASH OH
45242-7936
US
V. Phone/Fax
- Phone: 513-377-6417
- Fax:
- Phone: 513-377-6417
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | RP217207 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: