Provider Demographics
NPI:1083241723
Name:ROONEY, TAMMEY
Entity Type:Individual
Prefix:
First Name:TAMMEY
Middle Name:
Last Name:ROONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3225
Mailing Address - Country:US
Mailing Address - Phone:203-530-0494
Mailing Address - Fax:
Practice Address - Street 1:4 GROVE AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3225
Practice Address - Country:US
Practice Address - Phone:203-530-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist