Provider Demographics
NPI:1932769403
Name:TABOR, SARITA M (LAMFT)
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:M
Last Name:TABOR
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 CARRIAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2382
Mailing Address - Country:US
Mailing Address - Phone:507-430-0195
Mailing Address - Fax:
Practice Address - Street 1:3801 W 50TH ST STE 250B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2047
Practice Address - Country:US
Practice Address - Phone:612-787-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3488106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist