Provider Demographics
NPI:1386013902
Name:STROBLE, TAMARA (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:STROBLE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 WILLOW PT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-9418
Mailing Address - Country:US
Mailing Address - Phone:757-303-7176
Mailing Address - Fax:
Practice Address - Street 1:917 WILLOW PT
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-9418
Practice Address - Country:US
Practice Address - Phone:757-303-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004118235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist