Provider Demographics
NPI:1790204493
Name:PARRA, TARA SHAWN HAAG (PSYD, MA)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:SHAWN HAAG
Last Name:PARRA
Suffix:
Gender:F
Credentials:PSYD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11846 PEPPERVINE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-6311
Mailing Address - Country:US
Mailing Address - Phone:240-603-3169
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY STE 217
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7029
Practice Address - Country:US
Practice Address - Phone:240-232-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist