Provider Demographics
NPI:1790480945
Name:FAVORS, TASHA LASHAY
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:LASHAY
Last Name:FAVORS
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 1:1179 SCHUMARD AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2404
Mailing Address - Country:US
Mailing Address - Phone:513-485-5393
Mailing Address - Fax:513-826-5992
Practice Address - Street 1:1179 SCHUMARD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2404
Practice Address - Country:US
Practice Address - Phone:513-485-5393
Practice Address - Fax:513-826-5992
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health