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General NPI Number Information
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NPI Number | 1700223286
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Entity Type | Organization
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Legal Business Name | TARA MAHANEY, LLC
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Dates
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Enumeration Date | 05/24/2013
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 616 S CREYTS RD STE B
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City | LANSING
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State | MI
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Zip | 48917-8269
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Country | US
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Telephone | 517-282-2281
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Fax |
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Provider Business Mailing Address
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Address Line | 616 S CREYTS RD STE B
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City | LANSING
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State | MI
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Zip | 48917-8269
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Country | US
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Telephone | 517-282-2281
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TARA MAHANEY
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Credential |
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Telephone | 517-282-2281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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