Provider Demographics
NPI:1033300413
Name:BANE, TARA L (ATR)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:L
Last Name:BANE
Suffix:
Gender:F
Credentials:ATR
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:LAURENZANO-BANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATR
Mailing Address - Street 1:670 WOODBURNE RD
Mailing Address - Street 2:FAMILY SERVICE ASSOCIATION OF BUCKS COUNTY
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-757-6916
Mailing Address - Fax:215-757-2115
Practice Address - Street 1:670 WOODBURNE RD
Practice Address - Street 2:FAMILY SERVICE ASSOCIATION OF BUCKS COUNTY
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-757-6916
Practice Address - Fax:215-757-2115
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist