Provider Demographics
NPI:1659733566
Name:LARKINS, TARA (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:LARKINS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 MANDARIN DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-4936
Mailing Address - Country:US
Mailing Address - Phone:727-512-2916
Mailing Address - Fax:
Practice Address - Street 1:1030 MANDARIN DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-4936
Practice Address - Country:US
Practice Address - Phone:727-512-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist