Tara Rose Burchfield
Individual provider Active NPI Behavior Technician · Tamuning, GU
NPI 1760142780 · NPPES record last updated Dec 20, 2021
Key facts
- NPI
- 1760142780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-21-195954 (GU)
- Practice address
- 212 Farenholt Ave
Tamuning, GU 96913 - Phone
- (671) 649-7000
- NPI assigned
- Dec 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-195954 | GU | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-21-195954 | GU | Yes |
Addresses
Primary practice location
212 Farenholt Ave
Tamuning, GU 96913
Mailing address
212 Farenholt Ave
Tamuning, GA 96913
Phone (671) 649-7000
Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.