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General NPI Number Information
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NPI Number | 1992691489
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Entity Type | Individual
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Provider Name | TARA NOELLE EATON LSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 6985 TUTT BLVD STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3588
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Country | US
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Telephone | 719-624-0954
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 BEECHWOOD CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6417
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Country | US
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Telephone | 303-815-5398
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Fax | 303-815-5398
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009926417
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License Number State | CO
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