Individual
D'NICOLE M. TANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23 SUNNYBROOK RD, RALEIGH, NC 27610-1855
(919) 350-7584
(919) 231-0314
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(196) 278-5079
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C012167
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184918997
—
NC
Enumeration date
06/09/2011
Last updated
02/25/2021
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