Gibran Tatum, LPC

NPI #1982008074 in Ashland, Ohio

Provider Information

NPI Number: 1982008074
Entity Type: Individual
Name: Gibran Tatum, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Oct 17, 2014
Last Updated: Apr 21, 2020

Practice Location

Address: 1590 CRESTVIEW DR
City: Ashland
State: Ohio
ZIP Code: 44805-3560
Phone: (419) 289-0970

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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