Tasha J Temple, is a
Dietitian, Registered based in Lawrenceville, Georgia. Tasha J Temple is licensed to practice in Georgia (license number LD004513) and her current practice location is
1000 Medical Center Blvd, Lawrenceville, Georgia. She can be reached at her office (for appointments etc.) via phone at
(678) 312-6040.
NPI number for Tasha J Temple is 1912242785 and her current mailing address is 1920 Dembrigh Ln, Charlotte, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912242785.
Healthcare Provider's Profile
| Full Name | Tasha J Temple |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 1000 Medical Center Blvd, Lawrenceville, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1912242785
- Provider Enumeration Date: 12/05/2012
- Last Update Date: 04/18/2017
Medical Identifiers
Medical identifiers for Tasha J Temple such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912242785 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | LD004513 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tasha J Temple is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tasha J Temple,
1920 Dembrigh Ln,
Charlotte, NC 28262-2508
Ph: () - | Tasha J Temple,
1000 Medical Center Blvd,
Lawrenceville, GA 30046-7694
Ph: (678) 312-6040 |
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