| NPI | 1790002947 |
|---|---|
| Former Name | TARA PETTIT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001470) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1313) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2024-01-01 |