Provider Demographics
NPI:1568940898
Name:COX, TARI MADANE (MA)
Entity Type:Individual
Prefix:
First Name:TARI
Middle Name:MADANE
Last Name:COX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 RED CREST LN APT 112
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1398
Mailing Address - Country:US
Mailing Address - Phone:336-458-6536
Mailing Address - Fax:
Practice Address - Street 1:1401 E 7TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-6301
Practice Address - Country:US
Practice Address - Phone:704-728-0433
Practice Address - Fax:704-335-9918
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst