Provider Demographics
NPI:1356730675
Name:WARMAN, TATIANA MICHELLE
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:MICHELLE
Last Name:WARMAN
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 1:3090 SPRING HILL PKWY SE APT C
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4749
Mailing Address - Country:US
Mailing Address - Phone:720-206-4491
Mailing Address - Fax:
Practice Address - Street 1:3090 SPRING HILL PKWY SE APT C
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4749
Practice Address - Country:US
Practice Address - Phone:720-206-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0037642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer