Provider Demographics
NPI:1225273709
Name:SPOOR, TAMMY L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:SPOOR
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 ONEIL RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHAZY
Mailing Address - State:NY
Mailing Address - Zip Code:12992-2541
Mailing Address - Country:US
Mailing Address - Phone:518-561-9353
Mailing Address - Fax:
Practice Address - Street 1:430 ONEIL RD
Practice Address - Street 2:
Practice Address - City:WEST CHAZY
Practice Address - State:NY
Practice Address - Zip Code:12992-2541
Practice Address - Country:US
Practice Address - Phone:518-561-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist