Doctor Name: | TAMMY ROBERTSON |
NPI Number: | 1033396981 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMHT |
License Number: | |
Business Practice Address: | 104 New Hope Road Corinth, MS - 38834 |
Business Phone Number: | 6622877199 |
Business Fax Number: | 6622868095 |
Mailing Address: | Po Box 839, CORINTH |
State: | MS |
Postal Code: | 388350839 |
Phone Number: | 6622862152 |
Fax Number: | 6622868095 |
NPI Enumeration Date: | 01/23/2008 |
NPI Last Update Date: | 01/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |