Individual
MRS. TARA WITLIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 GENEVA ST, RALEIGH, NC 27606-2566
(919) 591-6227
Mailing address
1410 GENEVA ST, RALEIGH, NC 27606-2566
(919) 591-6227
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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