Tara Rayvonti, CPSS. B.S. FPSS
Case Manager/Care Coordinator in Paul, ID. Individual provider (NPI-1).
NPI number1124872072
StatusActive
Last updated in NPPESApr 16, 2024
Details
- NPI
- 1124872072
- Entity type
- Individual (NPI-1)
- Name
- Tara Rayvonti
- Credential
- CPSS. B.S. FPSS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 16, 2024
- Certification date
- Apr 16, 2024
- Last updated
- Apr 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 175T00000X | Peer Specialist | – | – |
Practice location
Po Box 754Paul, ID 83347-0754
Phone 208-878-8887 · Fax 208-878-6888
Mailing address
Po Box 754Paul, ID 83347-0754
Phone 208-878-8887 · Fax 208-878-6888
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