Provider Demographics
NPI:1679883391
Name:WOODRING-MALINICH, TAMMY (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:WOODRING-MALINICH
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:WOODRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3246 DRANE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16666
Mailing Address - Country:US
Mailing Address - Phone:814-577-0227
Mailing Address - Fax:
Practice Address - Street 1:1055 N FRONT ST
Practice Address - Street 2:SPACE 13
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8258
Practice Address - Country:US
Practice Address - Phone:814-577-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional