Provider Demographics
NPI:1497432819
Name:CORBIN, TANISHA LANAE
Entity Type:Individual
Prefix:
First Name:TANISHA
Middle Name:LANAE
Last Name:CORBIN
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 1:1355 CHESTERDALE DR APT B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2708
Mailing Address - Country:US
Mailing Address - Phone:216-212-5081
Mailing Address - Fax:
Practice Address - Street 1:1355 CHESTERDALE DR APT B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2708
Practice Address - Country:US
Practice Address - Phone:216-212-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care