Haley, Tara

Haley, Tara is an individual health care provider with primary practice located at 1955 Us Highway 1 S Suite C-2, St Augustine FL 32086-3708. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Haley, Tara can be contacted via phone (904) 825-5048.

Contact Information

Primary practice address
1955 Us Highway 1 S Suite C-2 St Augustine FL 32086-3708
Phone: (904) 825-5048
Fax: (904) 825-6824
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MT2076 Florida

Profile Details

NPI number 1528057916
LBN Legal business name Haley, Tara
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528057916 NPPES
Florida Other Z086J BCBS

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