MEDICARE: TARA M HUCEK

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
1	106S00000X	Behavior Technician	RBT-21-157833	TN

General Provider Information

NPI Number	:	1699431197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA M HUCEK

Provider Business Mailing Address
First Line	:	2121 AMANDA MEADOW CT
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076-3735
Country	:	US
Telephone Number	:	443-962-0494
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 AMANDA MEADOW CT
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076-3735
Country	:	US
Telephone Number	:	443-962-0494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	01/14/2026

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Directions to “ TARA M HUCEK ” Practice Location

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