| NPI | 1679926380 |
|---|---|
| Former Name | TARA ROCHELLE ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2019-01-10 |