Mitchell, Tiequenccia

Mitchell, Tiequenccia is an sole proprietor health care provider with primary practice located at 25 Woods Lake Rd Ste 506 , Greenville SC 29607-2767. She recently has 2 registered licenses in different health care specialties including Agencies / Home Health, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is her primary health care specialty. Mitchell, Tiequenccia can be contacted via phone (864) 552-1496.

Contact Information

Primary practice address
25 Woods Lake Rd Ste 506 Greenville SC 29607-2767
Fax: (864) 370-7200
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X IHCP-0345 South Carolina
Agencies / In Home Supportive Care 253Z00000X IHCP-0345 South Carolina

Profile Details

NPI number 1932553591
LBN Legal business name Mitchell, Tiequenccia
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2016
Last updated Oct 22nd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932553591 NPPES
South Carolina MEDICAID EX1476
South Carolina Other IHCP-0345

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