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NPI Code Detail

MEDICARE: TARA ANN EDMINSON LPC

MEDICARE: TARA ANN EDMINSON LPC
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
1101Y00000XCounselor15639AZ

General Provider Information

NPI Number : 1598537904
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA ANN EDMINSON LPC
Provider Business Mailing Address
First Line : 2806 N ALVERNON WAY STE 500
Second Line :
City : TUCSON
State : AZ
Zip : 85712-1567
Country : US
Telephone Number : 520-576-0377
Fax Number :
Provider Business Practice Location Address
First Line : 2806 N ALVERNON WAY STE 500
Second Line :
City : TUCSON
State : AZ
Zip : 85712-1567
Country : US
Telephone Number : 520-261-2328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 10/30/2023

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