Healthcare Provider Details

I. General information

NPI: 1215702394
Provider Name (Legal Business Name): TASHIA L MCNEIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 THORNWOOD DR
TOLEDO OH
43609-3526
US

IV. Provider business mailing address

PO BOX 510
TOLEDO OH
43697-0510
US

V. Phone/Fax

Practice location:
  • Phone: 419-503-6898
  • Fax:
Mailing address:
  • Phone: 419-320-8655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number23-6643-0845
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: