Provider Demographics
NPI:1760761324
Name:WINKENWERDER, TAMMY JO (LPC)
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:JO
Last Name:WINKENWERDER
Suffix:
Gender:F
Credentials:LPC
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Mailing Address - Street 1:9725 N LAKE CREEK PKWY
Mailing Address - Street 2:APT 3235
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-5906
Mailing Address - Country:US
Mailing Address - Phone:361-550-6850
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD
Practice Address - Street 2:STE 260-14
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3735
Practice Address - Country:US
Practice Address - Phone:254-471-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX18772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional