Provider Demographics
NPI:1972286847
Name:TARVER, CERIA TAPIKA (NBHWC)
Entity type:Individual
Prefix:
First Name:CERIA
Middle Name:TAPIKA
Last Name:TARVER
Suffix:
Gender:F
Credentials:NBHWC
Other - Prefix:
Other - First Name:CERIA
Other - Middle Name:TARVER
Other - Last Name:HAMLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1982 S HIDDEN HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-4013
Mailing Address - Country:US
Mailing Address - Phone:404-587-3416
Mailing Address - Fax:678-669-1945
Practice Address - Street 1:1982 S HIDDEN HILLS PKWY
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-4013
Practice Address - Country:US
Practice Address - Phone:404-587-3416
Practice Address - Fax:678-669-1945
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20194619171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach