Provider Demographics
NPI:1790318368
Name:REED, TAMARA BLANCHARD
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:BLANCHARD
Last Name:REED
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 1:1524 BALLINGER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6596
Mailing Address - Country:US
Mailing Address - Phone:832-512-9405
Mailing Address - Fax:
Practice Address - Street 1:8530 FM 1960 RD E STE 110
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1831
Practice Address - Country:US
Practice Address - Phone:832-262-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health