Individual
MRS. COLLEEN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
201 S 18TH ST APT 204, PHILADELPHIA, PA 19103-5919
(267) 520-0280
Mailing address
1924 MANTON ST, PHILADELPHIA, PA 19146-2925
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC009699
PA
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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