Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003393877 |
---|---|
Provider Name | Tara Smith |
First Address | Nashville, TN 37217-2679 |
Second Address | Tampa, FL 33629-1719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2018 |
Last Update Date | 09/12/2021 |