Individual
JUARIA TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
221700000X
Art Therapist
—
—
225800000X
Recreation Therapist
Primary
—
—
225A00000X
Music Therapist
—
—
226000000X
Recreational Therapist Assistant
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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