Provider Demographics
NPI:1346591781
Name:CHADWELL, TAMMIS A (MED, MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TAMMIS
Middle Name:A
Last Name:CHADWELL
Suffix:
Gender:F
Credentials:MED, MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 HESTERS CROSSING RD APT 3011
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-7810
Mailing Address - Country:US
Mailing Address - Phone:512-694-4247
Mailing Address - Fax:
Practice Address - Street 1:941 HESTERS CROSSING RD APT 3011
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-7810
Practice Address - Country:US
Practice Address - Phone:512-694-4247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104562235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist