Individual
TASHA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 HURON AVE, MEMPHIS, TN 38107-1405
(901) 860-3230
Mailing address
5957 BAIRD DR, MEMPHIS, TN 38119-7302
(901) 860-3230
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833104295
NEMT
TN
Enumeration date
01/30/2019
Last updated
03/13/2019
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