JAN MALLORY TATE

MEBANE, NC
NPI1508375973
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: NC  C012511)
Additional Taxonomies101YM0800X Counselor Mental Health
(Licence: NC  C012511)
1041C0700X Social Worker Clinical
(Licence: NC  P011313)
Enumeration Date2017-09-28
Last Update Date2022-10-18
Business Address
JAN MALLORY TATE LCSW, MED, CSOTP
105 E CENTER ST STE B-7
MEBANE, NC 27302-2420
Phone number: 917-773-8283
Mailing Address
JAN MALLORY TATE LCSW, MED, CSOTP
192 PEMBERTON ST
YANCEYVILLE, NC 27379-8008
Phone number: 917-773-8283