Provider Demographics
NPI:1699598722
Name:TARKINGTON, OLIVA (LPC)
Entity type:Individual
Prefix:MS
First Name:OLIVA
Middle Name:
Last Name:TARKINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W EUBANK ST
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-8350
Mailing Address - Country:US
Mailing Address - Phone:903-309-2563
Mailing Address - Fax:
Practice Address - Street 1:101 W EUBANK ST
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75147-8350
Practice Address - Country:US
Practice Address - Phone:903-309-2563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional