Individual
MS. TARA L ERNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
23107 E VIA DEL SOL, QUEEN CREEK, AZ 85142-1275
(480) 600-6838
(833) 623-4430
Mailing address
240 S MONTEZUMA ST STE 205206, PRESCOTT, AZ 86303-4712
(928) 756-0906
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19051
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710412382
NPI OF CLINICAL SUPERVISOR (MARIE TUELLER, MED, LPC)
AZ
Enumeration date
06/06/2022
Last updated
06/06/2022
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