Individual
TARA BARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
58 PHYSICIANS DR NW STE 106, SUPPLY, NC 28462-4216
(910) 755-6075
(910) 406-4111
Mailing address
58 PHYSICIANS DR NW STE 106, SUPPLY, NC 28462-4216
(910) 755-6075
(910) 406-4111
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
13630
NC
225X00000X
Occupational Therapist
Primary
13630
NC
Other
Enumeration date
10/20/2020
Last updated
02/09/2026
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