Individual
TAMMY RENEE TUBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
203 S VIENNA ST, RUSTON, LA 71270-4442
(318) 254-1234
(318) 254-1235
Mailing address
114 WOODSTONE DRIVE, RUSTON, LA 71270
(318) 202-5326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
2003
LA
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#2003
STATE OF LOUISIANA
LA
Enumeration date
06/02/2006
Last updated
01/04/2010
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