Provider Demographics
NPI:1205006947
Name:DEOLIVEIRA, TAMMY LR (MS CCC/A)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LR
Last Name:DEOLIVEIRA
Suffix:
Gender:F
Credentials:MS CCC/A
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:LYNN
Other - Last Name:RIEGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC/A
Mailing Address - Street 1:1600 ROCKLAND ROAD
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3607
Mailing Address - Country:US
Mailing Address - Phone:302-651-6465
Mailing Address - Fax:302-651-6219
Practice Address - Street 1:1600 ROCKLAND ROAD
Practice Address - Street 2:AUDIOLOGY DEPARTMENT
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-6465
Practice Address - Fax:302-651-6219
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD-000873237600000X
DEDE 02-0000168237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter