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General NPI Number Information
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NPI Number | 1407080690
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Entity Type | Individual
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Provider Name | TARA TZIPORA GREEN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 131 S FEDERAL HWY APT 305
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City | BOCA RATON
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State | FL
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Zip | 33432-4928
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Country | US
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Telephone | 973-303-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 131 S FEDERAL HWY APT 305
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City | BOCA RATON
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State | FL
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Zip | 33432-4928
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Country | US
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Telephone | 973-303-9484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 44SL05320500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23119
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License Number State | FL
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