| Tranquil Waves Therapy, Llc | |
|
601 Virginia Ave Suite 1 Tifton GA 31794 | |
| (229) 396-5507 | |
| (229) 396-5093 |
| Full Name | Tranquil Waves Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 601 Virginia Ave, Tifton, Georgia |
| Authorized Official Name and Position | Joanna Renee Taylor (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2293965507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tranquil Waves Therapy, Llc 16245 Valdosta Hwy Valdosta GA 31602-6066 Ph: (229) 740-5339 | Tranquil Waves Therapy, Llc 601 Virginia Ave Suite 1 Tifton GA 31794 Ph: (229) 396-5507 |
| NPI Number | 1033884747 |
|---|---|
| Provider Enumeration Date | 08/13/2021 |
| Last Update Date | 02/07/2022 |
| Certification Date | 02/07/2022 |
| Medicare PECOS PAC ID | 1153790449 |
|---|---|
| Medicare Enrollment ID | O20221208000860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033884747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joanna Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245840511 PECOS PAC ID: 6305212044 Enrollment ID: I20221020000790 |
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