Provider Demographics
NPI:1447015060
Name:TARA'S RESTORATION COUNSELING AND COACHING
Entity type:Organization
Organization Name:TARA'S RESTORATION COUNSELING AND COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:763-498-3068
Mailing Address - Street 1:411 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:OSSEO
Mailing Address - State:MN
Mailing Address - Zip Code:55369-1606
Mailing Address - Country:US
Mailing Address - Phone:763-498-3068
Mailing Address - Fax:
Practice Address - Street 1:411 3RD ST SE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1606
Practice Address - Country:US
Practice Address - Phone:763-498-3068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty