Provider Demographics
NPI:1275186363
Name:TARANTINO, AUBRIE (MA, NLC)
Entity Type:Individual
Prefix:
First Name:AUBRIE
Middle Name:
Last Name:TARANTINO
Suffix:
Gender:F
Credentials:MA, NLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1323
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-1323
Mailing Address - Country:US
Mailing Address - Phone:303-332-1156
Mailing Address - Fax:
Practice Address - Street 1:685 BRIGGS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516
Practice Address - Country:US
Practice Address - Phone:303-332-1156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0109271101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool