Individual
MRS. ELIZABETH A TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
610 W PEACE ST, RALEIGH, NC 27605-1520
(919) 413-0367
Mailing address
610 W PEACE ST, RALEIGH, NC 27605-1520
(919) 413-0367
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7741
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770808511
—
NC
Enumeration date
04/05/2010
Last updated
03/09/2011
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