Tara Ann Petersen

NPI #1760263040 in Ewa Beach, Hawaii

Provider Information

NPI Number: 1760263040
Entity Type: Individual
Name: Tara Ann Petersen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Oct 11, 2023
Last Updated: Oct 11, 2023

Practice Location

Address: 91-1841 FORT WEAVER RD
City: Ewa Beach
State: Hawaii
ZIP Code: 96706-1909
Phone: (808) 343-4495

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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