Provider Demographics
NPI:1578865648
Name:RICHARDSON-QUAMINA, TENILLE ANISE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TENILLE
Middle Name:ANISE
Last Name:RICHARDSON-QUAMINA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3721
Mailing Address - Country:US
Mailing Address - Phone:786-417-5878
Mailing Address - Fax:
Practice Address - Street 1:3950 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3721
Practice Address - Country:US
Practice Address - Phone:786-417-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCSW141181041C0700X
FLSW11236101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW11236OtherDEPARTMENT OF HEALTH - DIVSION OF MEDICAL QUALITY ASSURANCE