Provider Demographics
NPI:1497467880
Name:BARNHART, TAMMY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BARNHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:79562-3841
Mailing Address - Country:US
Mailing Address - Phone:325-214-0145
Mailing Address - Fax:
Practice Address - Street 1:102 BEAR CREEK DR
Practice Address - Street 2:
Practice Address - City:TUSCOLA
Practice Address - State:TX
Practice Address - Zip Code:79562-3841
Practice Address - Country:US
Practice Address - Phone:325-214-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-22-245722106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty