Tara Marie Nystrom MS, MHC

NPI 1235565722 - Counselor - 101YM0800X

NPI Details
NPI 1235565722
Gender Female
Enumeration Date 09/17/2013
Last Updated 09/17/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
3600 ROUTE 112
CORAM NY, 11727-4116, US
Phone (631) 920-8302
Fax (631) 920-8462
Business Location
3 N 2ND ST
HOLBROOK NY, 11741-1102, US
Phone (631) 648-8312
Taxonomy Code 101YM0800X
License State
License Number
Remove 1235565722 NPI Number

According to our database, Mrs. Tara Marie Nystrom MS, MHC NPI is 1235565722, taxonomy code is 101YM0800X Tara Marie Nystrom MS, MHC physically located at 3600 Route 112, Coram NY, 11727-4116. NPI Number Tara Marie Nystrom MS, MHC has the Individual type.

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1235565722 NPI number is provided on an as is basis without warranty of any kind. 1235565722 is maintained by the National Plan & Provider Enumeration System. The contents of Tara Marie Nystrom MS, MHC are for informational purposes only.