Individual
MS. TARA HARVEY-GROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
2413 N UNIVERSITY AVE, LAFAYETTE, LA 70507-5905
(337) 257-2688
(337) 234-1514
Mailing address
2413 N UNIVERSITY AVE, LAFAYETTE, LA 70507-5905
(337) 257-2688
(337) 234-1514
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTT.Z11532
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1068845
—
LA
Enumeration date
03/25/2007
Last updated
07/08/2007
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