Provider Demographics
NPI:1417623554
Name:CASH, TAMERA PAULINDA
Entity Type:Individual
Prefix:MS
First Name:TAMERA
Middle Name:PAULINDA
Last Name:CASH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAMERA
Other - Middle Name:PAULINDA
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:113 OAK GREEN DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-8704
Mailing Address - Country:US
Mailing Address - Phone:404-781-7529
Mailing Address - Fax:
Practice Address - Street 1:2810 PREMIERE PKWY STE 500
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8912
Practice Address - Country:US
Practice Address - Phone:866-523-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053353949106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician