Provider Demographics
NPI:1558868232
Name:MCCRORY, TAMMY (LLP BCBA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MCCRORY
Suffix:
Gender:F
Credentials:LLP BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38099 SCHOOLCRAFT RD STE 199
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1029
Mailing Address - Country:US
Mailing Address - Phone:734-796-7600
Mailing Address - Fax:
Practice Address - Street 1:38099 SCHOOLCRAFT RD STE 199
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1029
Practice Address - Country:US
Practice Address - Phone:734-796-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
MI6301016843103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst