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Individual

MRS. RITA MARIE TATTERSALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.A.C.

Contact information

Practice address
2765 ALBRIGHT RD STE A, KOKOMO, IN 46902-3996
(765) 450-9214
(765) 792-4234
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
87001602A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001602A
IN

Other

Enumeration date
03/20/2019
Last updated
12/01/2020
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