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Individual

MRS. PATRICIA TAPP FANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC/MHSP

Contact information

Practice address
100 5TH ST STE 310, BRISTOL, TN 37620-5919
(865) 281-1408
(865) 244-3579
Mailing address
100 5TH ST STE 310, BRISTOL, TN 37620-5919
(865) 281-1408
(865) 244-3579

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701004887
VA
101YP2500X
Professional Counselor
Primary
LPC0000001774
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC0000001774
LPC
TN
01
LPC0701004887
LPC
VA
Enumeration date
04/25/2013
Last updated
07/12/2021
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