Provider Demographics
NPI:1508573411
Name:REEVES, TONYA ROCHELLE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:ROCHELLE
Last Name:REEVES
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 1:1828 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1184
Mailing Address - Country:US
Mailing Address - Phone:614-282-9217
Mailing Address - Fax:
Practice Address - Street 1:1828 S 5TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1184
Practice Address - Country:US
Practice Address - Phone:614-282-9217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker