Individual
TARA MELOGRANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSW
Contact information
Practice address
1316 JACKIE RD SE STE 900, RIO RANCHO, NM 87124-6612
(505) 289-1042
Mailing address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
11/04/2024
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