Provider Demographics
NPI:1982444105
Name:REID-SANDERS, ASHANTA TALE
Entity type:Individual
Prefix:
First Name:ASHANTA
Middle Name:TALE
Last Name:REID-SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHANTA
Other - Middle Name:
Other - Last Name:REID-SANDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2416 CHINQUO ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1962 BROWN RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1201
Practice Address - Country:US
Practice Address - Phone:380-345-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner