Provider Demographics
NPI:1366494064
Name:BERAN, TARA OKEEFFE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:OKEEFFE
Last Name:BERAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:DAUN
Other - Last Name:OKEEFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5040 E SHEA BLVD STE 261
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4687
Mailing Address - Country:US
Mailing Address - Phone:602-264-3369
Mailing Address - Fax:602-264-3368
Practice Address - Street 1:5040 E SHEA BLVD STE 261
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4687
Practice Address - Country:US
Practice Address - Phone:602-264-3369
Practice Address - Fax:602-264-3368
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist