Provider Demographics
NPI:1740217306
Name:GADBOIS, TAMMY CATHERINE (MN/HS, CCC-A/SLP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:CATHERINE
Last Name:GADBOIS
Suffix:
Gender:F
Credentials:MN/HS, CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E VETERANS ST-126
Mailing Address - Street 2:
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-3105
Mailing Address - Country:US
Mailing Address - Phone:608-378-1291
Mailing Address - Fax:608-372-1294
Practice Address - Street 1:500 E VETERANS ST-126
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-3105
Practice Address - Country:US
Practice Address - Phone:608-378-1291
Practice Address - Fax:608-372-1294
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI256-156231H00000X
WI2137-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist