Provider Demographics
NPI:1386135507
Name:SHIPMAN-CURTIS, TESHA JO (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:TESHA
Middle Name:JO
Last Name:SHIPMAN-CURTIS
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CENTRAL PLZ N LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1448
Mailing Address - Country:US
Mailing Address - Phone:234-804-3008
Mailing Address - Fax:234-804-3024
Practice Address - Street 1:122 CENTRAL PLZ N LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1448
Practice Address - Country:US
Practice Address - Phone:234-804-3008
Practice Address - Fax:234-804-3024
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty