MEDICARE: TARA BECKFORD B.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1265858062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA BECKFORD B.A.

Provider Business Mailing Address
First Line	:	7621 LITTLE RD
Second Line	:	SUITE 200D
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-5567
Country	:	US
Telephone Number	:	727-494-7609
Fax Number	:

Provider Business Practice Location Address
First Line	:	7621 LITTLE RD
Second Line	:	SUITE 200D
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-5567
Country	:	US
Telephone Number	:	727-494-7609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2014
Last Update Date	:	03/17/2014

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