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General NPI Number Information
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NPI Number | 1922806702
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Entity Type | Individual
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Provider Name | TINASHIA SHANICE BRUNNER
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Gender | Female
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2306 GARRISON DR
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City | CINCINNATI
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State | OH
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Zip | 45231-2268
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Country | US
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Telephone | 513-687-9195
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Fax |
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Provider Business Mailing Address
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Address Line | 2306 GARRISON DR
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City | CINCINNATI
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State | OH
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Zip | 45231-2268
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Country | US
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Telephone | 513-687-9195
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | OH-14726-104709
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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