Individual
GIBRAN TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1590 CRESTVIEW DR, ASHLAND, OH 44805-3560
(419) 289-0970
Mailing address
1590 CRESTVIEW DR, ASHLAND, OH 44805-3560
(419) 289-0970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
080696
OH
101YP2500X
Professional Counselor
Primary
C1801524
OH
Other
Enumeration date
10/17/2014
Last updated
04/21/2020
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