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General NPI Number Information
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NPI Number | 1568696375
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Entity Type | Individual
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Provider Name | TARNICIA R DURHAM LPC
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Gender | Female
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 505 N SAM HOUSTON PKWY E STE 502
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City | HOUSTON
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State | TX
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Zip | 77060-4018
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Country | US
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Telephone | 281-447-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 3717 EMMET HUTTO BLVD APT 1105
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City | BAYTOWN
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State | TX
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Zip | 77521-1793
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Country | US
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Telephone | 601-214-1163
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 67426
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License Number State | TX
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