Healthcare Provider Details

I. General information

NPI: 1700749876
Provider Name (Legal Business Name): LAURA TARBERT MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 S DELAWARE AVE
YARDLEY PA
19067-1524
US

IV. Provider business mailing address

3645 GRIER NURSERY RD
STREET MD
21154-1332
US

V. Phone/Fax

Practice location:
  • Phone: 833-588-4375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC017108
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: