Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 225X00000X | Occupational Therapist |
NPI | 1891254686 |
---|---|
Provider Name | Tambria Means |
First Address | Shreveport, LA 71108-3102 |
Second Address | Shreveport, LA 71108-3102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 19/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00661 | (05) | LA |
27357 | (05) | LA |
87726 | (05) | LA |