| NPI | 1780118612 |
|---|---|
| Former Name | TARA CANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2021-05-27 |