Provider Demographics
NPI:1346754553
Name:O'BRIEN, TAMMYE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMMYE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials: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 1:1740 HUDSON BRIDGE RD STE 1208
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6331
Mailing Address - Country:US
Mailing Address - Phone:404-474-1627
Mailing Address - Fax:404-474-8937
Practice Address - Street 1:2724 WESLEY CHAPEL RD UNIT 361511
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30036-2357
Practice Address - Country:US
Practice Address - Phone:404-474-1627
Practice Address - Fax:404-474-8937
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist