Provider Demographics
NPI:1235889015
Name:REED, TARA MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:REED
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:MARIE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:947 BERMUDA ST
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-7515
Mailing Address - Country:US
Mailing Address - Phone:334-733-2317
Mailing Address - Fax:
Practice Address - Street 1:1880 S UNION AVE STE C
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-2944
Practice Address - Country:US
Practice Address - Phone:334-443-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-19-96404106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty