Provider Demographics
NPI:1326744905
Name:CURMON, TASHANNA
Entity Type:Individual
Prefix:
First Name:TASHANNA
Middle Name:
Last Name:CURMON
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 1:1918 LAKESIDE LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4166
Mailing Address - Country:US
Mailing Address - Phone:252-639-8911
Mailing Address - Fax:
Practice Address - Street 1:1918 LAKESIDE LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4166
Practice Address - Country:US
Practice Address - Phone:252-639-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician