Individual
J'KIA TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 CUMBERLAND AVE, WEST LAFAYETTE, IN 47906-1310
(219) 577-5721
Mailing address
1305 CUMBERLAND AVE STE 225, WEST LAFAYETTE, IN 47906-1343
(219) 577-5721
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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