Provider Demographics
NPI:1437494812
Name:MURPHY, TARA KRISTEN (MA TSSLD/SLP)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:KRISTEN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MA TSSLD/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ARROWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-3413
Mailing Address - Country:US
Mailing Address - Phone:516-729-6677
Mailing Address - Fax:
Practice Address - Street 1:31 ARROWOOD DR
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-3413
Practice Address - Country:US
Practice Address - Phone:516-729-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist