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NPI Code Detail

MEDICARE: TARA NICOLE HOLSTEIN PSY.D.

MEDICARE: TARA NICOLE HOLSTEIN PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist071008589IL

General Provider Information

NPI Number : 1336442557
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA NICOLE HOLSTEIN PSY.D.
Provider Business Mailing Address
First Line : 4104 EDEN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-3520
Country : US
Telephone Number : 312-248-4243
Fax Number :
Provider Business Practice Location Address
First Line : 6555 UPTON LN
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-4319
Country : US
Telephone Number : 312-248-4243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2010
Last Update Date : 12/04/2024

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