| NPI | 1679965438 |
|---|---|
| Former Name | TARRA LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH21446) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2022-08-17 |