Provider Demographics
NPI:1235714130
Name:MUCHIARONE, TAMARA NICOLE
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:NICOLE
Last Name:MUCHIARONE
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 1:3952 CLARERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3325
Mailing Address - Country:US
Mailing Address - Phone:419-494-6521
Mailing Address - Fax:
Practice Address - Street 1:TOLEDO CLINIC HEALTH EDUCATION
Practice Address - Street 2:4235 SECOR RD
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623
Practice Address - Country:US
Practice Address - Phone:419-469-6884
Practice Address - Fax:888-363-3695
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator