Provider Demographics
NPI:1184292377
Name:CURTNER, TAMIKA M
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:M
Last Name:CURTNER
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 1:1483 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2803
Mailing Address - Country:US
Mailing Address - Phone:937-423-6395
Mailing Address - Fax:
Practice Address - Street 1:1483 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2803
Practice Address - Country:US
Practice Address - Phone:937-423-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHS.2410672104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2410672OtherSOCIAL WORKER
OHS.2410672OtherSOCIAL WORKER