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Individual

MRS. TARA DENISE DORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
724 N 22ND ST, SAINT JOSEPH, MO 64506-2604
(816) 364-1501
Mailing address
323 MAIN STREET, PO BOX 83, NORTONVILLE, KS 66060
(573) 424-0292

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2019006598
MO

Other

Enumeration date
04/29/2020
Last updated
04/29/2020
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