Provider Demographics
NPI:1760239164
Name:SOWELL, TAIIJON
Entity type:Individual
Prefix:
First Name:TAIIJON
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 1:1710 EASTFIELD DR N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3716
Mailing Address - Country:US
Mailing Address - Phone:740-260-3146
Mailing Address - Fax:
Practice Address - Street 1:1710 EASTFIELD DR N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3716
Practice Address - Country:US
Practice Address - Phone:740-260-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 314000000X, 376K00000X
OH3747P1801X, 374U00000X, 385HR2060X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child