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
Phone: (864) 552-1496
Fax: (864) 370-7200
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1932553591 | NPPES |
South Carolina | MEDICAID | EX1476 | |
South Carolina | Other | IHCP-0345 |
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