Healthcare Provider Details
I. General information
NPI: 1023890258
Provider Name (Legal Business Name): IN THE HEART OF THE WOODS PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2023
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1102 A ST STE 302
TACOMA WA
98402-5001
US
IV. Provider business mailing address
1102 A ST STE 302
TACOMA WA
98402-5001
US
V. Phone/Fax
- Phone: 253-843-7791
- Fax: 253-201-4818
- Phone: 253-843-7791
- Fax: 253-201-4818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIN
C
TANSILL
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 253-843-7791