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Individual

TINA TARVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA, CCC-SLP

Contact information

Practice address
1104 DONOVAN AVE, BELLINGHAM, WA 98225-7325
(425) 429-4793
Mailing address
1104 DONOVAN AVE, BELLINGHAM, WA 98225-7325
(360) 393-5746

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20651
235Z00000X
Speech-Language Pathologist
LL 00004760
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LL 00004760
DEPARTMENT OF HEALTH
WA
Enumeration date
06/05/2014
Last updated
06/29/2016
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