Individual
LORI TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
804 ROBB ST, SUMMIT, MS 39666-8291
(601) 276-7665
(601) 276-7655
Mailing address
PO BOX 1268, SUMMIT, MS 39666-1268
(601) 276-7665
(601) 276-7655
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C5150
MS
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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