Provider Demographics
NPI:1124559265
Name:SATTERWHITE, TAMIKA (MED, QMHP-C, QMHP-A)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:SATTERWHITE
Suffix:
Gender:F
Credentials:MED, QMHP-C, QMHP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:NORTH DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23803-8882
Mailing Address - Country:US
Mailing Address - Phone:804-926-6139
Mailing Address - Fax:
Practice Address - Street 1:4512 WOODSTREAM DR
Practice Address - Street 2:
Practice Address - City:NORTH DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23803-8882
Practice Address - Country:US
Practice Address - Phone:804-926-6139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103T00000XBehavioral Health & Social Service ProvidersPsychologist