| NPI | 1831407402 |
|---|---|
| Former Name | CARRIE RENEE TARATUTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013964) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013964) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2020-06-16 |