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Individual

LOUIS WILLIAM TARASI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY 4860
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY 4860
FL
103TC0700X
Clinical Psychologist
Primary
PY 4860
FL

Other

Enumeration date
06/01/2011
Last updated
10/25/2011
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