Individual
MICHELLE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
85 KIRMAN AVE STE 200, RENO, NV 89502-1340
(775) 982-2862
(775) 982-2865
Mailing address
1155 MILL ST # MSM14, RENO, NV 89502-1576
(775) 982-5262
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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