Provider Demographics
NPI:1225534886
Name:TUMBLIN, DEANA
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:TUMBLIN
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:PO BOX 1158
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1158
Mailing Address - Country:US
Mailing Address - Phone:740-593-3402
Mailing Address - Fax:
Practice Address - Street 1:5860 FOX LAKE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-9265
Practice Address - Country:US
Practice Address - Phone:740-294-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker