| NPI | 1023489333 |
|---|---|
| Former Name | TARA PRADKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 098679) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801098078) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2024-01-05 |