Provider Information for 1568902765
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TABITHA MANN LCSW
Sex: Female
NPI: 1568902765
Last Updated: 2024-06-03
Certification Date: 2024-06-03
Certification Date: 2024-06-03
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1568902765 | ||||||||||||||||||||
| Enumeration Date | 2017-03-07 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 12191 CARDAMOM DR WOODBRIDGE, VA 22192-1448 United States Phone: 703-491-1913 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 12191 CARDAMOM DR WOODBRIDGE, VA 22192-1448 United States Phone: 703-491-1913 | Fax: | ||||||||||||||||||||
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