| NPI | 1568815967 |
|---|---|
| Former Name | TARA ANN COLLINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 33761) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2023-05-30 |