Provider Demographics
NPI:1972398485
Name:DECKER, TENICE
Entity type:Individual
Prefix:
First Name:TENICE
Middle Name:
Last Name:DECKER
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 1:53220 BELMONT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BEALLSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43716-9652
Mailing Address - Country:US
Mailing Address - Phone:740-408-3978
Mailing Address - Fax:740-408-3978
Practice Address - Street 1:53220 BELMONT RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEALLSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43716-9652
Practice Address - Country:US
Practice Address - Phone:740-408-3978
Practice Address - Fax:740-408-3978
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator