Provider Demographics
NPI:1740841550
Name:CRAIG, T'ARAH JULITA (LMT, CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:T'ARAH
Middle Name:JULITA
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LMT, CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 RIDGECREST CIR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-5405
Mailing Address - Country:US
Mailing Address - Phone:757-532-5303
Mailing Address - Fax:
Practice Address - Street 1:309 RIDGECREST CIR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-5405
Practice Address - Country:US
Practice Address - Phone:757-532-5303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-23
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
TXMT135977225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula