Individual
LISA MARIE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 LOCUST ST, DES MOINES, IA 50309-3718
(515) 883-2379
Mailing address
420 KELLOGG AVE, AMES, IA 50010-6226
(515) 233-3141
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
115298
IA
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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