Individual
TARA WIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 JERICHO TPKE STE 212, FLORAL PARK, NY 11001-2019
(516) 263-2375
(516) 856-2004
Mailing address
396 MANHATTAN AVE # 2L, BROOKLYN, NY 11211-1420
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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