Individual
JERREN PATRICK TATE-SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1030 LOFTIS BLVD, NEWPORT NEWS, VA 23606-2999
(757) 720-0099
Mailing address
303 DOGWOOD RD, YORKTOWN, VA 23690-3930
(509) 723-9767
(509) 723-9767
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-427030
VA
Other
Enumeration date
04/09/2025
Last updated
10/14/2025
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