Individual
PROF. TARA G MCMANAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. DIV, C.A.G.S.,
Contact information
Practice address
400 FARMINGTON RD W, ACCOKEEK, MD 20607-9412
(240) 776-2013
Mailing address
400 FARMINGTON RD W, ACCOKEEK, MD 20607-9412
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
715
WV
101YP2500X
Professional Counselor
Primary
LC4997
MD
225700000X
Massage Therapist
0076
WV
225700000X
Massage Therapist
01632
MD
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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