Individual
MRS. TARA LYNN FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
17 BERNON DR, LINCOLN, RI 02865-2329
(415) 322-8857
Mailing address
440 N BARRANCA AVE # 9605, COVINA, CA 91723-1722
(415) 320-6654
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/20/2016
Last updated
08/15/2024
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