Provider Demographics
NPI:1730154675
Name:YOUNG-BARBER, TAMI L (PHD)
Entity type:Individual
Prefix:DR
First Name:TAMI
Middle Name:L
Last Name:YOUNG-BARBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SOUTHERN DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-9730
Mailing Address - Country:US
Mailing Address - Phone:870-251-0458
Mailing Address - Fax:
Practice Address - Street 1:1800 MYERS ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7344
Practice Address - Country:US
Practice Address - Phone:870-793-8925
Practice Address - Fax:870-793-8929
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR96-09P103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S944Medicare ID - Type UnspecifiedPSYCHOLOGIST