Provider Demographics
NPI:1619647104
Name:THORNHILL, TAMARA RENEE (EDD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:RENEE
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1843
Mailing Address - Country:US
Mailing Address - Phone:412-371-3689
Mailing Address - Fax:
Practice Address - Street 1:7120 KELLY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1843
Practice Address - Country:US
Practice Address - Phone:412-371-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional