Provider Demographics
NPI:1831722164
Name:STUBBS, TINIKA RHONDA (HEALTH EDUCATOR)
Entity type:Individual
Prefix:
First Name:TINIKA
Middle Name:RHONDA
Last Name:STUBBS
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHESTNUT RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:215-317-4196
Mailing Address - Fax:
Practice Address - Street 1:3300 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1141
Practice Address - Country:US
Practice Address - Phone:215-473-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator