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Individual
TARA KNUTSEN
Active
Individual
TARA KNUTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011030263
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494159502
—
MO
Enumeration date
04/20/2010
Last updated
12/21/2020
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