Provider Demographics
NPI:1841071933
Name:WINSLOW, TASHONA (LMT, CD)
Entity type:Individual
Prefix:
First Name:TASHONA
Middle Name:
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:LMT, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11320 SERENITY FARM DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107-7504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11320 SERENITY FARM DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:NC
Practice Address - Zip Code:28107-7504
Practice Address - Country:US
Practice Address - Phone:704-642-9435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19071225700000X
SC9019225700000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist