Provider Demographics
NPI:1679981559
Name:TUZZEO, TARA (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:TUZZEO
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5317
Mailing Address - Country:US
Mailing Address - Phone:732-859-0571
Mailing Address - Fax:
Practice Address - Street 1:861 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5317
Practice Address - Country:US
Practice Address - Phone:732-859-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0-13-5444103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst