Provider Demographics
NPI:1417291618
Name:MEACHAM, TIARA LASHAWNTAE
Entity type:Individual
Prefix:MISS
First Name:TIARA
Middle Name:LASHAWNTAE
Last Name:MEACHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5366 MENDENHALL MALL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-4505
Mailing Address - Country:US
Mailing Address - Phone:901-842-3166
Mailing Address - Fax:
Practice Address - Street 1:5366 MENDENHALL MALL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4505
Practice Address - Country:US
Practice Address - Phone:901-842-3166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health