Provider Demographics
NPI:1073317954
Name:TARVER, ELIZABETH AYANI
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:AYANI
Last Name:TARVER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 BELGIAN CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-3524
Mailing Address - Country:US
Mailing Address - Phone:678-717-9909
Mailing Address - Fax:
Practice Address - Street 1:285 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7385
Practice Address - Country:US
Practice Address - Phone:470-944-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician