Provider Demographics
NPI:1235910753
Name:SALADIN, TASHA M (DOCTOR (DACM))
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:M
Last Name:SALADIN
Suffix:
Gender:F
Credentials:DOCTOR (DACM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-9222
Mailing Address - Country:US
Mailing Address - Phone:254-291-2275
Mailing Address - Fax:
Practice Address - Street 1:11325 54TH AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-9222
Practice Address - Country:US
Practice Address - Phone:254-291-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5402000046171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist