Individual
JOHN BENJAMIN DAVID TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DD PHD
Contact information
Practice address
99 DAWSON AVENUE, BACK DOOR @ TOP OF W/C RAMP, MANSFIELD, OH 44906-3201
(419) 524-8337
Mailing address
99 DAWSON AVENUE, BACK DOOR @ TOP OF W/C RAMP, MANSFIELD, OH 44906-3201
(419) 524-8337
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
146D00000X
Personal Emergency Response Attendant
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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