Provider Demographics
NPI:1174255632
Name:RECTOR, TAMMY MOXLEY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:MOXLEY
Last Name:RECTOR
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 1:6013 MONTICELLO DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8870
Mailing Address - Country:US
Mailing Address - Phone:704-701-6035
Mailing Address - Fax:
Practice Address - Street 1:6013 MONTICELLO DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8870
Practice Address - Country:US
Practice Address - Phone:704-701-6035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist