Tisha Mae Bates, LSW,MSW

NPI #1770146821 in Fairborn, Ohio

Provider Information

NPI Number: 1770146821
Entity Type: Individual
Name: Tisha Mae Bates, LSW,MSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LSW,MSW
Enumeration Date: Apr 15, 2019
Last Updated: Feb 8, 2022

Practice Location

Address: 188 W HEBBLE AVE
City: Fairborn
State: Ohio
ZIP Code: 45324-4960
Phone: (937) 754-5911

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Social Worker	104100000X	Primary

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