Individual
MS. TARA LYNN DIKEMAN
Active
Individual
MS. TARA LYNN DIKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.,OTR
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
5765
NC
225XP0200X
Pediatric Occupational Therapist
Primary
5905
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301830
—
NC
Enumeration date
12/14/2006
Last updated
02/04/2011
Update your record
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