Individual
TARA EADIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 FORT EUSTIS BLVD, YORKTOWN, VA 23692-4163
(757) 898-3746
Mailing address
16266 SMITHFIELD HEIGHTS DR, SMITHFIELD, VA 23430-7056
(201) 303-4118
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007149
VA
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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