Provider Demographics
NPI:1427040773
Name:TATNALL, DONNA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:TATNALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:335 RONDO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-6657
Mailing Address - Country:US
Mailing Address - Phone:828-859-7099
Mailing Address - Fax:828-859-0492
Practice Address - Street 1:100 JERVEY RD
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3642
Practice Address - Country:US
Practice Address - Phone:828-859-0492
Practice Address - Fax:828-859-0492
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0037391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical