Provider Demographics
NPI:1134800451
Name:HEAD, TESHIA NO TITLE PLEASE
Entity type:Individual
Prefix:
First Name:TESHIA
Middle Name:NO TITLE PLEASE
Last Name:HEAD
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 1:1571 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3563
Mailing Address - Country:US
Mailing Address - Phone:330-608-3832
Mailing Address - Fax:
Practice Address - Street 1:1571 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3563
Practice Address - Country:US
Practice Address - Phone:330-608-3832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty