Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YP2500X | Professional Counselor | FL | |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TF0200X | Forensic Psychologist |
NPI | 1659737237 |
---|---|
Provider Name | Tarra Duford |
First Address | Orlando, FL 32829-8047 |
Second Address | Orlando, FL 32829-8047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2016 |
Last Update Date | 12/01/2016 |