Provider Demographics
NPI:1982471942
Name:TARI, SHANIA (BA, MS)
Entity Type:Individual
Prefix:
First Name:SHANIA
Middle Name:
Last Name:TARI
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-6289
Mailing Address - Country:US
Mailing Address - Phone:972-533-2771
Mailing Address - Fax:
Practice Address - Street 1:801 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-6289
Practice Address - Country:US
Practice Address - Phone:972-533-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204854106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist