| Tanikka Mason | |
|
2002 Wakefield Ave Petersburg VA 23805-2112 | |
| (804) 733-1180 | |
| (804) 733-1181 |
| Full Name | Tanikka Mason |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2002 Wakefield Ave, Petersburg, Virginia |
| Authorized Official Name and Position | Tanikka Lashelle Mason (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 8047331180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanikka Mason 2002 Wakefield Ave Petersburg VA 23805-2112 Ph: (804) 733-1180 | Tanikka Mason 2002 Wakefield Ave Petersburg VA 23805-2112 Ph: (804) 733-1180 |
| NPI Number | 1285182246 |
|---|---|
| Provider Enumeration Date | 09/19/2016 |
| Last Update Date | 09/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285182246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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