| NPI | 1841700036 |
|---|---|
| Former Name | TARA SMITH MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.019343) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW80402) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2019-01-15 |