Individual
MICHELLE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0173421
NM
101YP2500X
Professional Counselor
Primary
CP5581-R
NV
106H00000X
Marriage & Family Therapist
IMF 60030
CA
Other
Enumeration date
05/30/2011
Last updated
01/10/2024
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