Individual
DENISE EVADNE TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10138 HULL STREET RD, MIDLOTHIAN, VA 23112-3357
(804) 744-1114
(804) 893-1114
Mailing address
3900 W BROAD ST, RICHMOND, VA 23230-3914
(804) 353-4461
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012754
VA
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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