Provider Demographics
NPI:1427198563
Name:COLON, TAMMIE (LSW)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W MARKET ST FL 5
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4868
Mailing Address - Country:US
Mailing Address - Phone:419-229-2222
Mailing Address - Fax:419-229-2227
Practice Address - Street 1:205 W MARKET ST FL 5
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4868
Practice Address - Country:US
Practice Address - Phone:419-229-2222
Practice Address - Fax:419-229-2227
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0018676101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor