Provider Demographics
NPI:1699036533
Name:KNOWLES, TSHAI
Entity Type:Individual
Prefix:MRS
First Name:TSHAI
Middle Name:
Last Name:KNOWLES
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:P.O BOX 222
Mailing Address - Street 2:
Mailing Address - City:GOLDENROD
Mailing Address - State:FL
Mailing Address - Zip Code:32733
Mailing Address - Country:US
Mailing Address - Phone:407-740-0428
Mailing Address - Fax:407-740-6471
Practice Address - Street 1:225 S SWOOPE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-740-0428
Practice Address - Fax:407-740-6471
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker