Provider Demographics
NPI:1043837040
Name:ROSEMOND, TIARA N (PHD, MPH, CHES)
Entity type:Individual
Prefix:DR
First Name:TIARA
Middle Name:N
Last Name:ROSEMOND
Suffix:
Gender:F
Credentials:PHD, MPH, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SUMTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2829
Mailing Address - Country:US
Mailing Address - Phone:803-296-5777
Mailing Address - Fax:
Practice Address - Street 1:1501 SUMTER ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2829
Practice Address - Country:US
Practice Address - Phone:803-296-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17511174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator