Individual
TARA LOMAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D
Contact information
Practice address
112 ASHWOOD PL, PEARL, MS 39208-5018
(251) 550-0852
Mailing address
112 ASHWOOD PL, PEARL, MS 39208-5018
(251) 550-0852
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
203026
MS
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
203026
MS
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
203026
MS
Other
Enumeration date
07/04/2024
Last updated
07/04/2024
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