Individual
TARA WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
701 W PINE ST, HATTIESBURG, MS 39401-3837
(601) 545-5614
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M7395
MS
1041C0700X
Clinical Social Worker
M7395
MS
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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