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NPI Code Detail

MEDICARE: MRS. TARA TUTTLE LMHC

MEDICARE: MRS. TARA TUTTLE LMHC
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
1101YM0800XMental Health Counselor39003234AIN

General Provider Information

NPI Number : 1437419314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA TUTTLE LMHC
Provider Business Mailing Address
First Line : 1928 HOMEWOOD AVE
Second Line :
City : MISHAWAKA
State : IN
Zip : 46544-2638
Country : US
Telephone Number : 574-387-7904
Fax Number :
Provider Business Practice Location Address
First Line : 401 W BRISTOL ST
Second Line :
City : ELKHART
State : IN
Zip : 46514-3019
Country : US
Telephone Number : 574-402-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2012
Last Update Date : 08/26/2024

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Directions to “ MRS. TARA TUTTLE LMHC” Practice Location

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