Basic Information
| Provider Information | |||||||||
| NPI: | 1215305289 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARROYO | ||||||||
| FirstName: | TASHANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1135 13TH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319012248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068875030 | ||||||||
| FaxNumber: | 7062431877 | ||||||||
| Practice Location | |||||||||
| Address1: | 1135 13TH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319012248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068875030 | ||||||||
| FaxNumber: | 7062431877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2015 | ||||||||
| LastUpdateDate: | 07/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101YM0800X | LPC010851 | GA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.