Provider Demographics
NPI:1952706145
Name:GUNNELL, TIARA (MS)
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:
Last Name:GUNNELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TIARA
Other - Middle Name:
Other - Last Name:GREENAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2315 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4602
Mailing Address - Country:US
Mailing Address - Phone:814-452-6558
Mailing Address - Fax:
Practice Address - Street 1:2315 MYRTLE ST STE 260
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4602
Practice Address - Country:US
Practice Address - Phone:814-452-6558
Practice Address - Fax:814-452-6554
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional