Provider Demographics
NPI:1275387573
Name:TATE, ISOBEL KATHERINE
Entity Type:Individual
Prefix:
First Name:ISOBEL
Middle Name:KATHERINE
Last Name:TATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WETZEL DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1131
Mailing Address - Country:US
Mailing Address - Phone:240-586-4381
Mailing Address - Fax:
Practice Address - Street 1:55 WETZEL DR STE 3
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1131
Practice Address - Country:US
Practice Address - Phone:717-465-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141369104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker