Fredericks, Tara
Fredericks, Tara is an individual health care provider with primary practice located at 939 Johnson Ave , Ronkonkoma NY 11779-6066. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Fredericks, Tara can be contacted via phone (631) 471-7242.Contact Information
Primary practice address
939 Johnson Ave
Ronkonkoma NY 11779-6066
Phone: (631) 471-7242
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 72071728 | New York |
Profile Details
| NPI number | 1245417005 |
|---|---|
| LBN Legal business name | Fredericks, Tara |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2008 |
| Last updated | Jan 23rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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