Healthcare Provider Details

I. General information

NPI: 1255823001
Provider Name (Legal Business Name): TARA JARRETT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 VETERANS DR
HARLINGEN TX
78550-8942
US

IV. Provider business mailing address

2601 VETERANS DR
HARLINGEN TX
78550-8942
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax:
Mailing address:
  • Phone: 402-319-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2723
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1055
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: