Individual
TASHAE STREETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ASSOCIATES OF SCIENC
Contact information
Practice address
4411 ROSEMONT DR, COLUMBUS, GA 31904-5634
(706) 327-0279
(706) 327-5294
Mailing address
6254 WARM SPRINGS RD APT K6, COLUMBUS, GA 31909-9165
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154315422
—
GA
Enumeration date
09/06/2017
Last updated
09/06/2017
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