Provider Demographics
NPI:1104034610
Name:TRAMEL, DASHELLA SAMARA
Entity Type:Individual
Prefix:MRS
First Name:DASHELLA
Middle Name:SAMARA
Last Name:TRAMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DASHELLA
Other - Middle Name:SAMARA
Other - Last Name:INNISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1045 ROEDEER DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-5970
Mailing Address - Country:US
Mailing Address - Phone:931-552-1605
Mailing Address - Fax:931-552-1605
Practice Address - Street 1:585 S. RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040
Practice Address - Country:US
Practice Address - Phone:931-503-0777
Practice Address - Fax:931-503-0703
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor