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Individual

MS. TARA SUZETTE HAZZARD-PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
600 MEDICAL DR, HAMPTON NEWPORT NEWS COMMUNITY SERVICES BOARD, HAMPTON, VA 23666-6079
(757) 788-0500
(757) 788-0928
Mailing address
300 MEDICAL DR, HAMPTON, VA 23666-1765
(757) 788-0300

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701004293
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427205151
NPI
05
49-45573
VA
Enumeration date
08/25/2008
Last updated
09/09/2008
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