Provider Demographics
NPI:1033980404
Name:MOLINA, TIYEISHA (CG,HCA,MH,BH)
Entity Type:Individual
Prefix:MRS
First Name:TIYEISHA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:CG,HCA,MH,BH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19B MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4875
Mailing Address - Country:US
Mailing Address - Phone:401-362-5988
Mailing Address - Fax:
Practice Address - Street 1:19 MIDDLE ST # B
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4875
Practice Address - Country:US
Practice Address - Phone:774-506-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMYCNAJOBS.COM374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide