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General NPI Number Information
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NPI Number | 1386206985
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Entity Type | Individual
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Provider Name | MUNIRAH AZIZA TARVER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 1711 E CENTRAL TEXAS EXPY STE 300F
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City | KILLEEN
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State | TX
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Zip | 76541-9120
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Country | US
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Telephone | 512-968-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 CAPRICE DR
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City | KILLEEN
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State | TX
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Zip | 76543-5773
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Country | US
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Telephone | 512-968-6717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74677
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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