Healthcare Provider Details

I. General information

NPI: 1912835067
Provider Name (Legal Business Name): TARA FOHT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ELM ST
ABRAMS WI
54101-9463
US

IV. Provider business mailing address

3000 ELM ST
ABRAMS WI
54101-9463
US

V. Phone/Fax

Practice location:
  • Phone: 920-826-5819
  • Fax:
Mailing address:
  • Phone: 920-826-5819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: