Provider Demographics
NPI:1740863943
Name:REAMS, TANITA SHARELL (LAC)
Entity type:Individual
Prefix:
First Name:TANITA
Middle Name:SHARELL
Last Name:REAMS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07522-1205
Mailing Address - Country:US
Mailing Address - Phone:973-641-4802
Mailing Address - Fax:
Practice Address - Street 1:22-08 ROUTE 208 STE 16
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2609
Practice Address - Country:US
Practice Address - Phone:201-956-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor