Provider Information for 1629138243
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
TARA MARIE NEAVINS PhD
Sex: Female
NPI: 1629138243
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629138243 | ||||||||
| Enumeration Date | 2006-12-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 351 SILVER ST DUTTON HOME RIVER VALLEY SERVICES MIDDLETOWN, CT 06457 United States Phone: 860-262-5358 | Fax:860-262-5356 | ||||||||
| Primary Practice Address | SILVER ST DUTTON HOME RIVER VALLEY SERVICES MIDDLETOWN, CT 06457 United States Phone: 860-262-5358 | Fax:860-262-5356 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|