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1164506192
TARA FAGAN
ORANGE PARK, FL
NPI
1164506192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA6601)
Enumeration Date
2006-10-25
Last Update Date
2013-05-30
Business Address
TARA FAGAN SLP
1639 MAJESTIC VIEW LN
ORANGE PARK, FL 32003-3223
Phone number: 904-635-4143
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Mailing Address
TARA FAGAN SLP
1639 MAJESTIC VIEW LN
ORANGE PARK, FL 32003-3223
Phone number: 904-635-4143
Copy
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