Provider Demographics
NPI:1639643604
Name:CORMIER, TINA SAVOY
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:SAVOY
Last Name:CORMIER
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 1:104 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-6810
Mailing Address - Country:US
Mailing Address - Phone:337-581-2032
Mailing Address - Fax:
Practice Address - Street 1:104 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-6810
Practice Address - Country:US
Practice Address - Phone:337-581-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health