Individual
TAMIA WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 AYERS CIR, SUMMERVILLE, SC 29485-3303
(843) 460-2605
(888) 298-0519
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-35253
SC
Other
Enumeration date
01/19/2018
Last updated
08/06/2026
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