Tyisha Kenshawna St. Surin
NPI #1972147171 in Fort Pierce, Florida
Provider Information
- NPI Number
- 1972147171
- Entity Type
- Individual
- Name
- Tyisha Kenshawna St. Surin
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Oct 30, 2019
- Last Updated
- Oct 30, 2019
Practice Location
- Address
- 2011 S 25TH ST STE 108
- City
- Fort Pierce
- State
- Florida
- ZIP Code
- 34947-4795
- Phone
- (561) 777-5156
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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