MEDICARE: TIARA ENSLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	103K00000X	Behavior Analyst	OH
2	374U00000X	Home Health Aide
3	343900000X	Non-emergency Medical Transport (VAN)
4	172A00000X	Driver
5	385H00000X	Respite Care	OH
6	101YM0800X	Mental Health Counselor	OH

General Provider Information

NPI Number	:	1922825835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIARA ENSLEY

Provider Business Mailing Address
First Line	:	1931 S OTTAWA COVE DR APT 3B
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-1482
Country	:	US
Telephone Number	:	419-283-5168
Fax Number	:

Provider Business Practice Location Address
First Line	:	TIARA ENSLEY
Second Line	:	1931 SOUTH OTTAWA COVE DRIVE 3B
City	:	TOLEDO
State	:	OH
Zip	:	43611
Country	:	US
Telephone Number	:	419-322-0516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	10/21/2025

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Directions to “ TIARA ENSLEY ” Practice Location

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