Tyeshia Monique Ravenel

NPI 1215296439 - Counselor - 101Y00000X

NPI Details
NPI 1215296439
Gender Female
Enumeration Date 05/08/2012
Last Updated 05/08/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
45 FOTTLER RD
APT 5
MATTAPAN MA, 02126-3140, US
Phone (857) 204-2638
Fax (617) 690-3534
Business Location
45 FOTTLER RD APT 5
MATTAPAN MA, 02126-3140, US
Phone (857) 204-2638
Fax (617) 690-3534
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Miss Tyeshia Monique Ravenel NPI is 1215296439, taxonomy code is 101Y00000X Tyeshia Monique Ravenel physically located at 45 Fottler Rd, Mattapan MA, 02126-3140. NPI Number Tyeshia Monique Ravenel has the Individual type.

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1215296439 NPI number is provided on an as is basis without warranty of any kind. 1215296439 is maintained by the National Plan & Provider Enumeration System. The contents of Tyeshia Monique Ravenel are for informational purposes only.