Individual
MISS TARA ELIZABETH EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
015190-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
111893
TX
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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