Provider Demographics
NPI:1710124409
Name:SNEED, TARA
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:SNEED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 FAIRMONT AVE
Mailing Address - Street 2:APT 102
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-5108
Mailing Address - Country:US
Mailing Address - Phone:559-824-1806
Mailing Address - Fax:
Practice Address - Street 1:287 FAIRMONT AVE
Practice Address - Street 2:APT 102
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-5108
Practice Address - Country:US
Practice Address - Phone:559-824-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)