Provider Demographics
NPI:1639971120
Name:FAIN, TIARRA (QMHP)
Entity type:Individual
Prefix:MISS
First Name:TIARRA
Middle Name:
Last Name:FAIN
Suffix:
Gender:
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SAGE RD APT 5102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-7063
Mailing Address - Country:US
Mailing Address - Phone:202-948-6125
Mailing Address - Fax:
Practice Address - Street 1:3300 SAGE RD APT 5102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-7063
Practice Address - Country:US
Practice Address - Phone:202-948-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health