Provider Demographics
NPI:1205099272
Name:ALTMAN, TARA B
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:B
Last Name:ALTMAN
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 1:1763 MAIN ST APT 123F
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6407
Mailing Address - Country:US
Mailing Address - Phone:727-366-3876
Mailing Address - Fax:
Practice Address - Street 1:2202 N WEST SHORE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5759
Practice Address - Country:US
Practice Address - Phone:727-366-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical