Provider Demographics
NPI:1598966020
Name:GUERRA, TAMMIE BIRD (CCCSLP)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:BIRD
Last Name:GUERRA
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BULLOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3928
Mailing Address - Country:US
Mailing Address - Phone:401-487-4973
Mailing Address - Fax:
Practice Address - Street 1:15 BULLOCK AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3928
Practice Address - Country:US
Practice Address - Phone:401-487-4973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01135235Z00000X
MA8448235Z00000X
IL146008726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist