Tisha Lee Koen is a Peer Specialist based in Eureka, CA. Tisha Lee Koen practices in Eureka, CA. The NPI Number for Tisha Lee Koen is 1235778465 and holds a License No. (California).
The current practice location address for Tisha Lee Koen is 2933 H St, Eureka, CA and can be reached out via phone at 707-441-3783.
Location: 2933 H St, Eureka, CA, 95501-2818
Provider Profile Details
NPI Number
1235778465
Provider Name
Tisha Lee Koen
Credential
Provider Entity Type
Individual
Gender
Female
Address
2933 H St, Eureka, CA, 95501-2818
Phone Number
707-441-3783
Fax Number
Provider Enumeration Date
01/06/2020
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
2933 H St
City
State
Zip
95501-4407
Phone Number
707-441-3783
Fax Number
Provider Business Mailing Address Details
Address
2933 H St
City
State
Zip
95501-4407
Phone Number
707-441-3783
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
(California)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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