Individual
JANE TASTET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHCA
Contact information
Practice address
1365 WESTGATE CENTER DR, WINSTON SALEM, NC 27103-2980
(336) 619-2680
Mailing address
5203 AMBERHILL DR, GREENSBORO, NC 27455-2211
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A19056
NC
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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