Provider Demographics
NPI:1861981755
Name:MILLER, TENESHA LYNN
Entity type:Individual
Prefix:
First Name:TENESHA
Middle Name:LYNN
Last Name:MILLER
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 1:3224 HADDINGTON DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5084
Mailing Address - Country:US
Mailing Address - Phone:614-572-4330
Mailing Address - Fax:
Practice Address - Street 1:3100 E 45TH ST STE 212
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1093
Practice Address - Country:US
Practice Address - Phone:216-341-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator