Individual
TARA PETTIT DELOACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
930 STEVENS CREEK RD STE 1, AUGUSTA, GA 30907-3200
(706) 343-3661
Mailing address
930 STEVENS CREEK RD STE 1, AUGUSTA, GA 30907-3200
(706) 343-3661
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1313
NC
106H00000X
Marriage & Family Therapist
Primary
MFT001470
GA
Other
Enumeration date
04/28/2010
Last updated
01/01/2024
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