Provider Demographics
NPI:1891925053
Name:CHASE, TARA CROWLEY (MASTER OF ARTS, SPEE)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:CROWLEY
Last Name:CHASE
Suffix:
Gender:F
Credentials:MASTER OF ARTS, SPEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1891 GOODYEAR AVE
Mailing Address - Street 2:SUITE #605
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-642-8490
Mailing Address - Fax:805-659-9955
Practice Address - Street 1:1891 GOODYEAR AVE
Practice Address - Street 2:SUITE #605
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-642-8490
Practice Address - Fax:805-659-9955
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP#3333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist