Doctor Name: | MRS. TAMARA MARIE LOTT |
NPI Number: | 1013037373 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC, CRC |
License Number: | 180-003547 |
Business Practice Address: | 515 Ne Glen Oak Ave Ste 101 Osf Saint Francis Medical Center Peoria, IL - 616033167 |
Business Phone Number: | 3096557795 |
Business Fax Number: | 3096554609 |
Mailing Address: | 5503 N Pepperwood Ct, PEORIA |
State: | IL |
Postal Code: | 616153273 |
Phone Number: | 3092560114 |
Fax Number: | 3096554609 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 01/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 180-003547 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |