Provider Demographics
NPI:1598989998
Name:AYSCUE, TAMMIE (BS)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:AYSCUE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 LODGE AVE # A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-1526
Mailing Address - Country:US
Mailing Address - Phone:812-402-3975
Mailing Address - Fax:
Practice Address - Street 1:1510 W FRANKLIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1032
Practice Address - Country:US
Practice Address - Phone:812-424-0223
Practice Address - Fax:812-424-0226
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)