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1235565722
TARA MARIE NYSTROM
CORAM, NY
NPI
1235565722
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-09-17
Last Update Date
2013-09-17
Business Address
Mrs. TARA MARIE NYSTROM MS, MHC
3600 ROUTE 112
CORAM, NY 11727-4116
Phone number: 631-920-8302
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Mailing Address
Mrs. TARA MARIE NYSTROM MS, MHC
3 N 2ND ST
HOLBROOK, NY 11741-1102
Phone number: 631-648-8312
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