Individual
TARA L GOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS 1917
Contact information
Practice address
209 MARTIN LUTHER KING JR. DR., ELIZABETHTOWN, NC 28337-2833
(910) 247-6822
(910) 247-6829
Mailing address
209 MARTIN LUTHER KING JR. DR., ELIZABETHTOWN, NC 28337-7770
(910) 247-6822
(910) 247-6829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1917
NC
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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