Provider Demographics
NPI:1538962303
Name:POOLE, TIA L (FIRST AID, CPR, FCCP)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:L
Last Name:POOLE
Suffix:
Gender:
Credentials:FIRST AID, CPR, FCCP
Other - Prefix:
Other - First Name:TIA
Other - Middle Name:L
Other - Last Name:LOVE-HART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:308 POINTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2850
Mailing Address - Country:US
Mailing Address - Phone:937-623-4813
Mailing Address - Fax:
Practice Address - Street 1:308 POINTVIEW AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2850
Practice Address - Country:US
Practice Address - Phone:937-623-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No376J00000XNursing Service Related ProvidersHomemaker