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NPI Code Detail

MEDICARE: TARI MADANE COX M.A.

MEDICARE: TARI MADANE COX M.A.
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1568940898
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARI MADANE COX M.A.
Provider Business Mailing Address
First Line : 10210 RED CREST LN APT 112
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-1398
Country : US
Telephone Number : 336-458-6536
Fax Number :
Provider Business Practice Location Address
First Line : 1401 E 7TH ST STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-6301
Country : US
Telephone Number : 704-728-0433
Fax Number : 704-335-9918
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2018
Last Update Date : 11/26/2018

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