Provider Demographics
NPI:1760668594
Name:TAMM, CHRISTINE DAWN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DAWN
Last Name:TAMM
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N 7TH ST STE C5
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2710
Mailing Address - Country:US
Mailing Address - Phone:208-771-6249
Mailing Address - Fax:951-530-8310
Practice Address - Street 1:118 N 7TH ST STE C5
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2710
Practice Address - Country:US
Practice Address - Phone:208-771-6249
Practice Address - Fax:951-530-8310
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID6516106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist