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General NPI Number Information
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NPI Number | 1962799338
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Entity Type | Individual
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Provider Name | TARA JANAE MINNIX-HARMON AU.D., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 508 NEW HOPE ROAD SUITE #19
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City | PRINCETON
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State | WV
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Zip | 24740-2272
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Country | US
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Telephone | 304-487-2487
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Fax | 304-431-3367
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Provider Business Mailing Address
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Address Line | 508 NEW HOPE ROAD SUITE #19
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City | PRINCETON
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State | WV
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Zip | 24740-2272
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Country | US
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Telephone | 304-487-2487
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Fax | 304-431-3367
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-0276
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License Number State | WV
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