Most Relevant Information
Provider Data
| NPI Number: | 1003520289 |
| Provider Name: | SHANTORIA TATUM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/11/2023 |
| Last Updated: | 01/11/2023 |
Provider Practice Location
875 RAYS BRIDGE RD STE 103
WHISPERING PINES
NC
283275910
Practice Location Phone/Fax
| Phone: | 8883928642 |
| Fax: |
Provider Mailing Location
214 SECOND ST
FAYETTEVILLE
NC
283010200
Provider Mailing Phone/Fax
| Phone: | 7694288734 |
| Fax: |