Individual
ALICIA TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
971 E WICHITA AVE, RUSSELL, KS 67665-2444
(785) 377-4744
Mailing address
3834 N OLIVER ST, BEL AIRE, KS 67220-2042
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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