Provider Demographics
NPI:1659718906
Name:TARLTON, AMBER GAIL (MS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:GAIL
Last Name:TARLTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:GAIL
Other - Last Name:TARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:211 JUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5642
Mailing Address - Country:US
Mailing Address - Phone:702-399-2769
Mailing Address - Fax:702-399-0271
Practice Address - Street 1:211 JUDSON AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5642
Practice Address - Country:US
Practice Address - Phone:702-399-2769
Practice Address - Fax:702-399-0271
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health