Basic Information
| Provider Information | |||||||||
| NPI: | 1548456288 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TATE | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 903 BIRD SONG DR | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483811505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486768685 | ||||||||
| FaxNumber: | 2486768685 | ||||||||
| Practice Location | |||||||||
| Address1: | 1270 DORIS RD | ||||||||
| Address2: | |||||||||
| City: | AUBURN HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483262617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484102598 | ||||||||
| FaxNumber: | 2482769280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2007 | ||||||||
| LastUpdateDate: | 09/17/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801086897 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.