Individual
TARA NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 GROVE CIR, STATESBORO, GA 30458-0401
(678) 249-4598
Mailing address
33 GROVE CIR, STATESBORO, GA 30458-0401
(678) 249-4598
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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