| NPI | 1346455169 |
|---|---|
| Former Name | TARA LYNN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P1110085) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A0803025) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2018-03-08 |