Individual
LASHONNA DENISE TINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6500 KIRBY GATE BLVD, MEMPHIS, TN 38119-2673
(901) 752-0772
Mailing address
4 1 3 0 CHERYL DR, MEMPHIS, TN 38116
(901) 215-8217
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
455154
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111111111111
THERAPY
TN
05
—
1528728193
—
TN
Enumeration date
12/23/2021
Last updated
12/27/2021
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