MRS. Tara Nicole Misner, DT

NPI #1790517282 in Charleston, Illinois

Provider Information

NPI Number: 1790517282
Entity Type: Individual
Name: MRS. Tara Nicole Misner, DT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Credential: DT
Enumeration Date: Aug 14, 2024
Last Updated: Aug 14, 2024

Practice Location

Address: 1000 11TH ST
City: Charleston
State: Illinois
ZIP Code: 61920-2843
Phone: (217) 208-9763

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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