Basic Information
| Provider Information | |||||||||
| NPI: | 1871086595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARKOWSKI | ||||||||
| FirstName: | TARI | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | RBT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 CONGRESSIONAL BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460325632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172492242 | ||||||||
| FaxNumber: | 3176631175 | ||||||||
| Practice Location | |||||||||
| Address1: | 2555 YEAGER RD | ||||||||
| Address2: | |||||||||
| City: | WEST LAFAYETTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 479061335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652697756 | ||||||||
| FaxNumber: | 3176631175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2018 | ||||||||
| LastUpdateDate: | 06/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 103K00000X | 12042456 | IN | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.