Most Relevant Information
Provider Data
| NPI Number: | 1003462755 |
| Provider Name: | TARA SUE HUPP CDCA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/16/2019 |
| Last Updated: | 08/16/2019 |
Provider Practice Location
1791 ALUM CREEK DR
COLUMBUS
OH
432071708
Practice Location Phone/Fax
| Phone: | 6144458131 |
| Fax: |
Provider Mailing Location
1791 ALUM CREEK DR
COLUMBUS
OH
432071708
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |