| NPI | 1134608441 |
|---|---|
| Former Name | TARA MARIE SEGREST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00629900) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00285600) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2024-09-25 |