Provider Demographics
NPI:1942933197
Name:HARBERT, TAMARA L (BCBA)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:L
Last Name:HARBERT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 BRISBANE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4923
Mailing Address - Country:US
Mailing Address - Phone:505-456-6474
Mailing Address - Fax:
Practice Address - Street 1:121 VISION PARK BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3028
Practice Address - Country:US
Practice Address - Phone:505-456-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5149103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst