Individual
ASHLEY TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
114 E CRANDALL AVE STE B, HARRISON, AR 72601-3628
(870) 741-8484
(870) 741-4088
Mailing address
2153 E JOYCE BLVD STE 201, FAYETTEVILLE, AR 72703-5285
(479) 575-9471
(479) 587-9392
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9963-M
AR
171M00000X
Case Manager/Care Coordinator
0000
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14616315
CAQH
—
Enumeration date
02/03/2020
Last updated
09/02/2020
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