Provider Demographics
NPI:1265842348
Name:COOK WASHINGTON, TAMARA (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:COOK WASHINGTON
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:L
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC/SLP
Mailing Address - Street 1:8983 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6217
Mailing Address - Country:US
Mailing Address - Phone:205-370-3229
Mailing Address - Fax:
Practice Address - Street 1:8983 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6217
Practice Address - Country:US
Practice Address - Phone:205-370-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12923235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist