Tara Nicole Ditter

NPI #1144793993 in Kimberly, Wisconsin

Provider Information

NPI Number: 1144793993
Entity Type: Individual
Name: Tara Nicole Ditter
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 4, 2019
Last Updated: Jan 4, 2019

Practice Location

Address: 569 CARTER CT
City: Kimberly
State: Wisconsin
ZIP Code: 54136-2201
Phone: (920) 739-3009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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