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General NPI Number Information
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NPI Number | 1851971386
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Entity Type | Individual
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Provider Name | TYTESHA D AVILES
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Gender | Female
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 7825 MIDLOTHIAN TPKE STE 119
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-5247
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Country | US
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Telephone | 804-847-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 7505 WINNING COLORS PL
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-6192
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Country | US
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Telephone | 804-482-9118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 1401085972
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 1401085972
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License Number State | VA
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