Individual
TARA BODLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1022 S 51ST ST STE 200, PHOENIX, AZ 85004-2133
(402) 553-3000
Mailing address
1022 S 51ST ST STE 200, PHOENIX, AZ 85004-2133
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20933
AZ
Other
Enumeration date
09/04/2020
Last updated
09/27/2023
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