Individual
TARA MARIE FETHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1019 E WATER ST, ELMIRA, NY 14901-3332
(607) 733-5696
Mailing address
1019 E WATER ST, ELMIRA, NY 14901-3332
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
12/07/2010
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