Doctor Name: | MRS. TARA MADISON |
NPI Number: | 1104162668 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 844116 |
Business Practice Address: | 1053 Saw Mill River Rd Ardsley, NY - 105021048 |
Business Phone Number: | 9146740733 |
Business Fax Number: | |
Mailing Address: | 1053 Saw Mill River Rd, ARDSLEY |
State: | NY |
Postal Code: | 105021048 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/02/2013 |
NPI Last Update Date: | 01/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 844116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |