Provider Demographics
NPI:1851782858
Name:EISENACHER, TARA (AT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:EISENACHER
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:HANDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AT
Mailing Address - Street 1:2204 JULIE TER
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3963
Mailing Address - Country:US
Mailing Address - Phone:513-608-9396
Mailing Address - Fax:
Practice Address - Street 1:1 TIGER TRL
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-1976
Practice Address - Country:US
Practice Address - Phone:513-608-9396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0049662255A2300X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer