Healthcare Provider Details

I. General information

NPI: 1982769063
Provider Name (Legal Business Name): TARA D ORAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 MEDICAL PARK DR SUITE 400
LENOIR CITY TN
37772-5640
US

IV. Provider business mailing address

6800 BAUM DR BUILDING 1
KNOXVILLE TN
37919-7315
US

V. Phone/Fax

Practice location:
  • Phone: 865-374-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: