Provider Demographics
NPI:1740534171
Name:HALE, TENIQUA MARSHAE'
Entity type:Individual
Prefix:
First Name:TENIQUA
Middle Name:MARSHAE'
Last Name:HALE
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 1:1475 CUNARD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-3295
Mailing Address - Country:US
Mailing Address - Phone:614-702-8945
Mailing Address - Fax:
Practice Address - Street 1:1475 CUNARD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-3295
Practice Address - Country:US
Practice Address - Phone:614-702-8945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide