Provider Demographics
NPI:1902430226
Name:SOWELL, TIANNE
Entity type:Individual
Prefix:
First Name:TIANNE
Middle Name:
Last Name:SOWELL
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 1:1880 LITTLE WATER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-6241
Mailing Address - Country:US
Mailing Address - Phone:614-822-1239
Mailing Address - Fax:
Practice Address - Street 1:1880 LITTLE WATER DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-6241
Practice Address - Country:US
Practice Address - Phone:614-822-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health