Individual
TARA JOY DELA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 8TH ST S STE 200, MOORHEAD, MN 56560-4200
(218) 331-4866
(218) 331-4867
Mailing address
2405 8TH ST S STE 200, MOORHEAD, MN 56560-4200
(218) 331-4866
(218) 331-4867
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2735
MN
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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