Individual
TARA BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 ELM ST, MADISON, IN 47250-3316
(812) 265-3448
Mailing address
701 ELM ST, MADISON, IN 47250-3316
(812) 265-3448
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1491618
IN
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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