Most Relevant Information
Provider Data
| NPI Number: | 1003527631 |
| Provider Name: | TARA RENEE MUMA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/05/2022 |
| Last Updated: | 12/05/2022 |
Provider Practice Location
903 NORTHEAST DR STE 201
DAVIDSON
NC
280367438
Practice Location Phone/Fax
| Phone: | 7048967776 |
| Fax: |
Provider Mailing Location
903 NORTHEAST DR STE 201
DAVIDSON
NC
280367438
Provider Mailing Phone/Fax
| Phone: | 7048967776 |
| Fax: |