Individual
JOHN TATE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APSW
Contact information
Practice address
420 7TH ST, RACINE, WI 53403-1222
(262) 634-2391
Mailing address
2044 KINZIE AVE, RACINE, WI 53405-2612
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
130356-121
WI
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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