| NPI | 1205358900 |
|---|---|
| Former Name | TARA BOCKRATH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146014009) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 15736) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2026-03-19 |