Individual
TARA O'SULLIVAN DYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1316 APACHE AVE, SANTA FE, NM 87505
(310) 721-4398
Mailing address
1316 APACHE AVE, SANTA FE, NM 87505-3212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
75454
TX
101YP2500X
Professional Counselor
Primary
CBT-2022-0761
NM
Other
Enumeration date
06/07/2018
Last updated
02/25/2025
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