Provider Demographics
NPI:1225886633
Name:RISSOVER, TENLEY (MT-BC, TRCC)
Entity type:Individual
Prefix:
First Name:TENLEY
Middle Name:
Last Name:RISSOVER
Suffix:
Gender:F
Credentials:MT-BC, TRCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7374 READING RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3400
Mailing Address - Country:US
Mailing Address - Phone:513-910-5123
Mailing Address - Fax:
Practice Address - Street 1:7374 READING RD STE 206
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-3400
Practice Address - Country:US
Practice Address - Phone:513-987-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17704225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist