Individual
TARA ANNE GROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
158 HARMON DR # 201, NORTHFIELD, VT 05663-1000
(704) 223-4436
Mailing address
158 HARMON DR # 201, NORTHFIELD, VT 05663-1000
(704) 223-4436
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/28/2021
Last updated
11/28/2021
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