| Doctor Name: | TARA MCDONALD |
| NPI Number: | 1063852770 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | MC13797 |
| Business Practice Address: | 283 Elm St Biddeford, ME - 040053027 |
| Business Phone Number: | 2072823351 |
| Business Fax Number: | |
| Mailing Address: | 283 Elm St, BIDDEFORD |
| State: | ME |
| Postal Code: | 040053027 |
| Phone Number: | 2072823351 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2013 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MC13797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |