Tara M Jackson in Auburn - Developmental Therapist
Tara M Jackson - NPI 1578784245
Tara M Jackson is a Developmental Therapist in Auburn, Kentucky. Tara M Jackson practices all healthcare services and medical treatments related to Developmental Therapist. The NPI Number for Tara M Jackson is 1578784245. The last update date is 2020-04-29.
Tara M Jackson's current location address is 104 G Corum Ln, Auburn, Kentucky. You can contact this provider via phone number 2708477004 and fax number 2705422519. The mailing address for Tara M Jackson is 104 G Corum Ln, Auburn, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tara M Jackson |
|---|---|
| Address | 104 G Corum Ln, Auburn, Kentucky |
| Phone Number | 2708477004 |
| Fax Number | 2705422519 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1578784245 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2020-04-29 |
Provider Mailing Address Detail
| Address | 104 G Corum Ln |
|---|---|
| City | Auburn |
| State | Kentucky (KY) |
| Post Code | 422065000 |
| Phone Number | 2708477004 |
| Fax Number | 2705422519 |
Provider's Primary Taxonomy Detail
| Speciality | Developmental Therapist |
|---|---|
| Taxonomy | 222Q00000X |
|
Definition: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Tara M Jackson by the Centers for Medicare & Medicaid Services?
The Tara M Jackson has been issued the NPI (National Provider Identifier) 1578784245 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Tara M Jackson is located?
The Tara M Jackson is situated at the following address: 104 G Corum Ln, Auburn, KY, 422065000.
What is the Tara M Jackson's area of specialization and corresponding taxonomy classification?
The Tara M Jackson's specialty field is Developmental Therapist, and it falls under the taxonomy code 222Q00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1578784245 to Tara M Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1578784245 to Tara M Jackson on 2007-05-01.
As of what date were the details related to Tara M Jackson most recently updated or revised?
The information pertaining to Tara M Jackson, including its address, specialty, and other relevant details, was last updated or revised on 2020-04-29.
NPI Number: 1679570980
Address: 333 S Beaudry Ave, Los Angeles, CA