Individual
MRS. TARA BETH LUELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPA
Contact information
Practice address
5838 SIX FORKS RD, SUITE 200, RALEIGH, NC 27609-3885
(919) 785-9944
(919) 785-9992
Mailing address
617 ANCIENT OAKS DR, HOLLY SPRINGS, NC 27540-7986
(573) 888-7598
(919) 346-1011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0935
KY
103TC0700X
Clinical Psychologist
Primary
4097
NC
Other
Enumeration date
02/28/2011
Last updated
04/03/2012
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