Individual
TARA LYNN WEIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1347 MONTERREY BLVD, #182, EULESS, TX 76040-8111
(817) 312-7540
Mailing address
1347 MONTERREY BLVD, #182, EULESS, TX 76040-8111
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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