Provider Demographics
NPI:1407981418
Name:BROWN, TAMMY (PLPC)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-1943
Mailing Address - Country:US
Mailing Address - Phone:417-681-0065
Mailing Address - Fax:417-681-0071
Practice Address - Street 1:100 E 11TH ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-1943
Practice Address - Country:US
Practice Address - Phone:417-681-0065
Practice Address - Fax:417-681-0071
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006037784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional