Tara Fulton-Butzlaff's National Provider Identifier (NPI) Details
Tara Fulton-Butzlaff, LCSW
NPI: 1073900544
Enumeration Date: 2015-04-22
Last updated: 2015-07-27
Sole Proprietor: YES
Status: active
Postal Address: 707 CORINNE ST, HATTIESBURG, MS
Phone: 601-408-6284
Primary Practice Address: 707 CORINNE ST, HATTIESBURG, MS
Practice's phone: 601-408-6284