Provider Demographics
NPI:1720831159
Name:EATON, TIERNI LEIGH (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:TIERNI
Middle Name:LEIGH
Last Name:EATON
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1294 TRINITY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17368-9206
Mailing Address - Country:US
Mailing Address - Phone:240-855-7526
Mailing Address - Fax:
Practice Address - Street 1:1294 TRINITY CHURCH RD
Practice Address - Street 2:
Practice Address - City:WRIGHTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17368-9206
Practice Address - Country:US
Practice Address - Phone:240-855-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAA-3665306171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty