Individual
MRS. TANGIE MARTIN MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PIP
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
(205) 558-4783
Mailing address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
(205) 558-4758
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1799G
AL
Other
Enumeration date
01/08/2010
Last updated
12/04/2012
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