Individual
TARA FORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 CHAMBERLAINE AVE, POTTSVILLE, PA 17901-8648
(570) 593-5484
Mailing address
1502 ROUTE 61 HWY S, POTTSVILLE, PA 17901-8409
(570) 593-5484
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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