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Individual

TARA ROSE BURCHFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
212 FARENHOLT AVE, TAMUNING, GU 96913
(671) 649-7000
Mailing address
212 FARENHOLT AVE, TAMUNING, GA 96913
(671) 649-7000

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-195954
GU

Other

Enumeration date
12/20/2021
Last updated
12/20/2021
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