Tara Anderson
Prevention Professional in Maysville, KY. Individual provider (NPI-1).
NPI number1083174866
StatusActive
Last updated in NPPESMar 20, 2019
Details
- NPI
- 1083174866
- Entity type
- Individual (NPI-1)
- Name
- Tara Anderson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 20, 2019
- Last updated
- Mar 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 405300000X | Prevention Professional | 000000 | KY | Yes |
Practice location
611 Forest AveMaysville, KY 41056-1411
Phone 606-564-4016 · Fax 606-564-8288
Mailing address
611 Forest AveMaysville, KY 41056-1411
Phone 606-564-4016 · Fax 606-564-8288
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