Provider Demographics
NPI:1659824050
Name:CLINE, TAMMY (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:CLINE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-1963
Mailing Address - Country:US
Mailing Address - Phone:605-366-2053
Mailing Address - Fax:
Practice Address - Street 1:1600 N WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-0447
Practice Address - Country:US
Practice Address - Phone:605-367-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD268-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist