Individual
TARA LYNN MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1721 ROLLETT LN, EVANSVILLE, IN 47712-4013
(812) 205-6525
Mailing address
1721 ROLLETT LN, EVANSVILLE, IN 47712-4013
(812) 205-6525
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005188A
IN
235Z00000X
Speech-Language Pathologist
Primary
3683
KY
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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