| NPI | 1265728265 |
|---|---|
| Former Name | TARA ELIZABETH GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34010508A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 6082) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-07-17 |