Doctor Name: | TAMI A FERGUSON |
NPI Number: | 1013133529 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6802064353 |
Business Practice Address: | 303 W Water St Suite 108 Flint, MI - 485035627 |
Business Phone Number: | 8102322766 |
Business Fax Number: | 8102322782 |
Mailing Address: | 286 Alfred St, MONTROSE |
State: | MI |
Postal Code: | 484579154 |
Phone Number: | 8102322766 |
Fax Number: | 8102322782 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6802064353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |