Provider Demographics
NPI:1215111554
Name:TARVER, ALEADA (PHD)
Entity type:Individual
Prefix:
First Name:ALEADA
Middle Name:
Last Name:TARVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALEADA
Other - Middle Name:
Other - Last Name:LEE-TARVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:617 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4958
Mailing Address - Country:US
Mailing Address - Phone:334-887-2233
Mailing Address - Fax:334-887-2030
Practice Address - Street 1:1784 ELKAHATCHEE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-4800
Practice Address - Country:US
Practice Address - Phone:256-329-0868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1436103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist