Healthcare Provider Details

I. General information

NPI: 1730154675
Provider Name (Legal Business Name): TAMI L YOUNG-BARBER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 12/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MYERS ST
BATESVILLE AR
72501-7344
US

IV. Provider business mailing address

80 SOUTHERN DR
BATESVILLE AR
72501-9730
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-8925
  • Fax: 870-793-8929
Mailing address:
  • Phone: 870-251-0458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number96-09P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: