| NPI | 1811252430 |
|---|---|
| Former Name | TARA MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0170481) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0170481) |
| 101YM0800X Counselor, Mental Health (Licence: WA MC60292704) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-07-22 |