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Individual

TARA K DIGGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MORT/L

Contact information

Practice address
119 BETH ANN DR, WINFIELD, MO 63389-2001
(573) 318-4365
Mailing address
119 BETH ANN DR, WINFIELD, MO 63389-2001
(573) 318-4365

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2016004144
MO
225X00000X
Occupational Therapist
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477046233
MO
Enumeration date
06/07/2018
Last updated
01/24/2022
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