Individual
JOSEPH S TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1221 LEE STREET, CHARLOTTESVILLE, VA 22908-0816
(434) 243-5868
(434) 243-2916
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0805002162
VA
103TC0700X
Clinical Psychologist
Primary
0805002162
VA
Other
Enumeration date
04/11/2019
Last updated
07/29/2021
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