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General NPI Number Information
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NPI Number | 1417201310
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Entity Type | Individual
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Provider Name | ALICIA TETTEH ASW
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Gender | Female
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 2301 COLLEY AVE # 6101
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City | NORFOLK
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State | VA
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Zip | 23517-1144
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Country | US
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Telephone | 980-288-5486
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Fax | 704-247-5355
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Provider Business Mailing Address
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Address Line | 2301 COLLEY AVE # 6101
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City | NORFOLK
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State | VA
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Zip | 23517-1144
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Country | US
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Telephone | 980-288-5486
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Fax | 704-247-5355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C010048
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904017643
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License Number State | VA
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