Most Relevant Information
Provider Data
| NPI Number: | 1003405150 |
| Provider Name: | TARA L DERMON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/13/2021 |
| Last Updated: | 01/13/2021 |
Provider Practice Location
2600 VICTORY PKWY
CINCINNATI
OH
452061395
Practice Location Phone/Fax
| Phone: | 5137717747 |
| Fax: |
Provider Mailing Location
2600 VICTORY PKWY
CINCINNATI
OH
452061395
Provider Mailing Phone/Fax
| Phone: | 5137717747 |
| Fax: |