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Individual

TANGELLA FOREMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4001 COMMERCIAL CENTER DR STE 2, MARION, AR 72364-9616
(870) 732-7920
Mailing address
2809 FOREST HOME RD, JONESBORO, AR 72401-5320
(866) 972-1268

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4946-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
226890719
AR
Enumeration date
07/11/2011
Last updated
09/30/2020
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