Healthcare Provider Details

I. General information

NPI: 1366367252
Provider Name (Legal Business Name): TARA BESNER NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8103 APPALACHIAN TER
POTOMAC MD
20854-4050
US

IV. Provider business mailing address

8103 APPALACHIAN TER
POTOMAC MD
20854-4050
US

V. Phone/Fax

Practice location:
  • Phone: 240-304-0298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number09880
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: