Provider Demographics
NPI:1982225645
Name:PALMA, TARA JUDITH (LSW)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:JUDITH
Last Name:PALMA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:JUDITH
Other - Last Name:PALMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:705 QUAIL RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 SPRINGDALE RD STE 150
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2728
Practice Address - Country:US
Practice Address - Phone:856-424-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker