| NPI | 1871119826 |
|---|---|
| Former Name | TARA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0031477) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 355630) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2023-05-01 |