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Individual

TARA M VINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1401 20TH ST S, BIRMINGHAM, AL 35205-4913
(205) 510-2778
(205) 510-2790
Mailing address
333 BUSINESS CIR, PELHAM, AL 35124-1778
(205) 510-2780
(205) 510-2790

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2556
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511-082541
BLUE CROSS BLUE SHIELD OF AL.
AL
Enumeration date
05/18/2010
Last updated
09/21/2010
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