Provider Demographics
NPI:1265042519
Name:HOEWISCHER, TAMMY SUE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:SUE
Last Name:HOEWISCHER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:WHITSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BOSTWICK
Mailing Address - State:FL
Mailing Address - Zip Code:32007-0306
Mailing Address - Country:US
Mailing Address - Phone:386-546-5354
Mailing Address - Fax:
Practice Address - Street 1:224 BOSTWICK CEMETERY RD
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-8184
Practice Address - Country:US
Practice Address - Phone:386-546-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician