Individual
TARA LEANNE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 E DIXIE AVE, ELIZABETHTOWN, KY 42701-1162
(270) 765-9478
Mailing address
PO BOX 6098, ELIZABETHTOWN, KY 42702-6098
(270) 765-9478
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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