Provider Demographics
NPI:1447578141
Name:ADAMSON, TARA DEVONE (CMHC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:DEVONE
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 HERITAGE PARK BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5679
Mailing Address - Country:US
Mailing Address - Phone:801-510-9081
Mailing Address - Fax:
Practice Address - Street 1:476 HERITAGE PARK BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5679
Practice Address - Country:US
Practice Address - Phone:801-510-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6781151-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health