Provider Demographics
NPI:1376425629
Name:HAVIOR, CURRITIOUS TYRESE
Entity type:Individual
Prefix:
First Name:CURRITIOUS
Middle Name:TYRESE
Last Name:HAVIOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HARMONY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-9010
Mailing Address - Country:US
Mailing Address - Phone:478-361-0484
Mailing Address - Fax:
Practice Address - Street 1:333 HARMONY CHURCH RD
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-9010
Practice Address - Country:US
Practice Address - Phone:478-361-0484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN297502163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health