Provider Demographics
NPI:1073035887
Name:HEARD, TIA MARIE
Entity Type:Individual
Prefix:MS
First Name:TIA
Middle Name:MARIE
Last Name:HEARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4591 QUINCY AVENUE BUILDING Q
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104
Mailing Address - Country:US
Mailing Address - Phone:216-355-1335
Mailing Address - Fax:
Practice Address - Street 1:4591 QUINCY AVENUE BUILDING Q
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104
Practice Address - Country:US
Practice Address - Phone:216-355-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health