Provider Demographics
NPI:1760210785
Name:DOSS, TIANA LACHEA (CPR FIRST AID)
Entity type:Individual
Prefix:MISS
First Name:TIANA
Middle Name:LACHEA
Last Name:DOSS
Suffix:
Gender:F
Credentials:CPR FIRST AID
Other - Prefix:MISS
Other - First Name:TIANA
Other - Middle Name:LACHEA
Other - Last Name:DOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPR
Mailing Address - Street 1:11281 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1843
Mailing Address - Country:US
Mailing Address - Phone:770-309-9194
Mailing Address - Fax:
Practice Address - Street 1:11281 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1843
Practice Address - Country:US
Practice Address - Phone:770-309-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician