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General NPI Number Information
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NPI Number | 1821694134
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Entity Type | Individual
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Provider Name | TAHIRAH NA'ILAH PATTERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 10967 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32825-4457
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Country | US
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Telephone | 407-276-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 1942 CONWAY RD
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City | ORLANDO
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State | FL
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Zip | 32812-9137
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Country | US
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Telephone | 407-728-1710
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Fax |
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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 | SW22224
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License Number State | FL
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