Provider Demographics
NPI:1376093823
Name:BELLAMY, TIJUANA (MA, MBA)
Entity Type:Individual
Prefix:
First Name:TIJUANA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 HILSON HEAD LN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-5366
Mailing Address - Country:US
Mailing Address - Phone:678-775-8051
Mailing Address - Fax:678-825-2828
Practice Address - Street 1:3260 HILSON HEAD LN
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-5366
Practice Address - Country:US
Practice Address - Phone:678-775-8051
Practice Address - Fax:678-825-2828
Is Sole Proprietor?:No
Enumeration Date:2016-10-08
Last Update Date:2016-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program