Provider Demographics
NPI:1992319883
Name:WASHINGTON, TALEASHA LINTAYVIA
Entity type:Individual
Prefix:MS
First Name:TALEASHA
Middle Name:LINTAYVIA
Last Name:WASHINGTON
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 1:7404 WOODHILL PARK DR APT 1307
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6592
Mailing Address - Country:US
Mailing Address - Phone:407-255-5803
Mailing Address - Fax:
Practice Address - Street 1:2012 CABO SAN LUCAS DR APT 208
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8435
Practice Address - Country:US
Practice Address - Phone:407-255-5803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X, 171W00000X, 101YM0800X, 172V00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
No171W00000XOther Service ProvidersContractor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker