| Doctor Name: | TAMECA WALKER TINES |
| NPI Number: | 1063805950 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LC2027 |
| Business Practice Address: | 8620 Rolling Rd Manassas, VA - 201103828 |
| Business Phone Number: | 7032574661 |
| Business Fax Number: | 7032574771 |
| Mailing Address: | 5635 Sheals Ln, CENTREVILLE |
| State: | VA |
| Postal Code: | 201201976 |
| Phone Number: | 3014047474 |
| Fax Number: | |
| NPI Enumeration Date: | 03/16/2015 |
| NPI Last Update Date: | 03/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC2027 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |