Individual
RICHARD TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
226 OVEROOK PARK LN, LAWRENCEVILLE, GA 30043
(770) 549-5118
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
048149
NY
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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