Individual
TARA RACHELLE PORTERLIVESAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
501 N 9TH ST, TEMPLE, TX 76501-3150
(347) 476-0073
Mailing address
501 N 9TH ST, TEMPLE, TX 76501-3150
(347) 476-0073
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99422
TX
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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