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NPI Code Detail

MEDICARE: TARA WILLIAMS

MEDICARE:   TARA  WILLIAMS
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
1103K00000XBehavior Analyst1-24-71270FL

General Provider Information

NPI Number : 1659887016
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA WILLIAMS
Provider Business Mailing Address
First Line : 990 CORAL RIDGE DR APT 204
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-4169
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 824 S LAKE DR
Second Line :
City : LANTANA
State : FL
Zip : 33462-4626
Country : US
Telephone Number : 561-523-2011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2017
Last Update Date : 02/15/2024

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Directions to “ TARA WILLIAMS ” Practice Location

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