Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 00284-IG | NV |
NPI | 1003106345 |
---|---|
Provider Name | Tara Barrett |
First Address | Las Vegas, NV 89139-7789 |
Second Address | Henderson, NV 89012-3494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 13/03/2018 |