Individual
TARA HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, COBA
Contact information
Practice address
5929 WAYNEGATE RD, HUBER HEIGHTS, OH 45424-1157
(937) 545-0140
Mailing address
5929 WAYNEGATE RD, HUBER HEIGHTS, OH 45424-1157
(937) 545-0140
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
BACB#1-16-23725
OH
103K00000X
Behavior Analyst
Primary
COBA #286
OH
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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