| Doctor Name: | TARA ANN O'SHEA |
| NPI Number: | 1053562165 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CAP |
| License Number: | SW8633 |
| Business Practice Address: | 518 Sw Prima Vista Blvd Port St Lucie, FL - 34983 |
| Business Phone Number: | 7723442293 |
| Business Fax Number: | 7723442253 |
| Mailing Address: | 518 Sw Prima Vista Blvd, PORT ST LUCIE |
| State: | FL |
| Postal Code: | 34983 |
| Phone Number: | 7723442293 |
| Fax Number: | 7723442253 |
| NPI Enumeration Date: | 10/07/2008 |
| NPI Last Update Date: | 08/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW8633 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |