Provider Demographics
NPI:1114295581
Name:WILLS, TAMARA LYNNE (CPM)
Entity Type:Individual
Prefix:MISS
First Name:TAMARA
Middle Name:LYNNE
Last Name:WILLS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02471-0084
Mailing Address - Country:US
Mailing Address - Phone:610-217-4294
Mailing Address - Fax:
Practice Address - Street 1:14 MAGNOLIA RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1622
Practice Address - Country:US
Practice Address - Phone:610-217-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife