Provider Demographics
NPI:1356948384
Name:LARDE, TANETIA YVETTE (HOME CARE ATTENDANT)
Entity type:Individual
Prefix:
First Name:TANETIA
Middle Name:YVETTE
Last Name:LARDE
Suffix:
Gender:F
Credentials:HOME CARE ATTENDANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E PARK ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-1815
Mailing Address - Country:US
Mailing Address - Phone:419-244-9115
Mailing Address - Fax:
Practice Address - Street 1:15 E PARK ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1815
Practice Address - Country:US
Practice Address - Phone:419-244-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide