Provider Demographics
NPI:1558143800
Name:GOLDEN-HARPER, TAMANTHA DEMETRIUS (EDD, LGPC)
Entity type:Individual
Prefix:DR
First Name:TAMANTHA
Middle Name:DEMETRIUS
Last Name:GOLDEN-HARPER
Suffix:
Gender:F
Credentials:EDD, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11217 HERON PL APT B
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4824
Mailing Address - Country:US
Mailing Address - Phone:252-340-5955
Mailing Address - Fax:
Practice Address - Street 1:2670 CRAIN HWY STE 205
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2816
Practice Address - Country:US
Practice Address - Phone:301-818-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional