Provider Demographics
NPI:1144407362
Name:HARRIS, TAMARA (LPC)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:M
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC,
Mailing Address - Street 1:1702 BLUE HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-9519
Mailing Address - Country:US
Mailing Address - Phone:281-415-5816
Mailing Address - Fax:281-431-1537
Practice Address - Street 1:1702 BLUE HEATHER LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-9519
Practice Address - Country:US
Practice Address - Phone:281-415-5816
Practice Address - Fax:281-431-1537
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional