Provider Demographics
NPI:1609453711
Name:DYE, TAMARA ROCHELLE
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ROCHELLE
Last Name:DYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37153 W AMALFI AVE
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-5199
Mailing Address - Country:US
Mailing Address - Phone:480-208-5712
Mailing Address - Fax:
Practice Address - Street 1:37153 W AMALFI AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-5199
Practice Address - Country:US
Practice Address - Phone:480-208-5712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool