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MONIQUE TATE PHD

Pastoral >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1679064596

Individual Registrant:
 MONIQUE  TATE PHD
Gender: F
Sole Proprietor

Location and contact information for practice:
124 SAUNDERS ST  FLOVILLA, GA 30216-2106 US
Tel: 678-752-8455  Fax: --

Contact information for business:
PO BOX 1841  JACKSON, GA 30233-0036 US
Tel: 678-774-8057  Fax: --

Registration Information:
NPI: 1679064596
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YP1600XBehavioral Health & Social Service Providers
Counselor
Pastoral
N174400000XOther Service Providers
Specialist
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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