Doctor Name: | TAMARA MARIE GEORGE |
NPI Number: | 1073808796 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 604 E College St Carbondale, IL - 629013309 |
Business Phone Number: | 6184576707 |
Business Fax Number: | 6185294563 |
Mailing Address: | 604 E College St, CARBONDALE |
State: | IL |
Postal Code: | 629013309 |
Phone Number: | 6184576707 |
Fax Number: | 6185294563 |
NPI Enumeration Date: | 06/10/2011 |
NPI Last Update Date: | 06/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |