Provider Demographics
NPI:1609175181
Name:CARRARA, TAMMARA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMMARA
Middle Name:
Last Name:CARRARA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4866
Mailing Address - Country:US
Mailing Address - Phone:802-772-0172
Mailing Address - Fax:888-751-6009
Practice Address - Street 1:25 CURTIS AVE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4866
Practice Address - Country:US
Practice Address - Phone:802-772-0172
Practice Address - Fax:888-751-6009
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist