Individual
MRS. TARA BECKER MCCARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD
Contact information
Practice address
146 N HOSPITAL DR, STE120, WEST COLUMBIA, SC 29169-4800
(803) 936-7530
(803) 936-7532
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
3401
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP4644
MEDICAID GROUP NUMBER
SC
05
—
SA0761
—
SC
Enumeration date
07/31/2006
Last updated
11/09/2020
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