Provider Demographics
NPI:1821376856
Name:TARNAWSKI, EVA (MA)
Entity Type:Individual
Prefix:MISS
First Name:EVA
Middle Name:
Last Name:TARNAWSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 VILLAGE SQUARE DR APT 33
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1236
Mailing Address - Country:US
Mailing Address - Phone:860-916-1621
Mailing Address - Fax:
Practice Address - Street 1:1738 ELLINGTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2773
Practice Address - Country:US
Practice Address - Phone:860-916-1621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist