Individual
TARA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 S COWAN RD, MUNCIE, IN 47302-9431
(765) 624-6320
Mailing address
3205 S MADISON ST, MUNCIE, IN 47302-5604
(765) 624-6320
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102105135299
—
IN
Enumeration date
03/08/2022
Last updated
03/08/2022
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