Provider Demographics
NPI:1588841027
Name:HARGROVE, TAMMY (MSCCC/SLP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HARGROVE
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 MCALLISTER DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-3205
Mailing Address - Country:US
Mailing Address - Phone:256-837-8585
Mailing Address - Fax:256-837-2214
Practice Address - Street 1:4411 MCALLISTER DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-3205
Practice Address - Country:US
Practice Address - Phone:256-837-8585
Practice Address - Fax:256-837-2214
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist