Individual
TARA L SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 425-3274
(575) 758-2043
Mailing address
412 SIPAPU ST, TAOS, NM 87571-6498
(575) 425-3274
(575) 758-2043
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73725773
—
NM
Enumeration date
09/14/2021
Last updated
09/14/2021
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