Provider Demographics
NPI:1568284651
Name:LENOIR, TIEIOKO
Entity type:Individual
Prefix:
First Name:TIEIOKO
Middle Name:
Last Name:LENOIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7737
Mailing Address - Country:US
Mailing Address - Phone:219-315-7861
Mailing Address - Fax:
Practice Address - Street 1:4300 OHIO ST
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7737
Practice Address - Country:US
Practice Address - Phone:219-315-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator