Provider Demographics
NPI:1639267131
Name:WELKER, TARA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:MARIE
Last Name:WELKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 N MILLER RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3619
Mailing Address - Country:US
Mailing Address - Phone:602-568-4618
Mailing Address - Fax:
Practice Address - Street 1:4300 N MILLER RD
Practice Address - Street 2:SUITE 137
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3619
Practice Address - Country:US
Practice Address - Phone:602-568-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3596103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical