| NPI | 1497426712 |
|---|---|
| Former Name | TARA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851114805) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-01785) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2022-06-01 |