Individual
TARA T FESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RCSWI
Contact information
Practice address
300 S 6TH ST, FORT PIERCE, FL 34950-4221
(772) 252-1125
Mailing address
300 S 6TH ST, FORT PIERCE, FL 34950-4221
(772) 252-1125
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
ISW7898
FL
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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