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Individual

MRS. TIA RAE TAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
12422 E MANSFIELD AVE APT 90, SPOKANE VALLEY, WA 99216-1167
(509) 990-6104
Mailing address
816 W FRANCIS AVE UNIT 516, SPOKANE, WA 99205-6512
(509) 990-6104

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
174400000X
Specialist
Primary
MA00018360
WA

Other

Enumeration date
02/28/2007
Last updated
02/24/2023
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