| NPI | 1598246225 |
|---|---|
| Former Name | TARA VICTORIA BUTRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 11035) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 4356) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2023-06-27 |