Provider Demographics
NPI:1003030743
Name:VILLINES, TAMMY RENEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:RENEE
Last Name:VILLINES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10135 STERLING TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4637
Mailing Address - Country:US
Mailing Address - Phone:301-527-8727
Mailing Address - Fax:
Practice Address - Street 1:9302 SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4831
Practice Address - Country:US
Practice Address - Phone:301-562-8861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04255103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical