Provider Demographics
NPI:1851158133
Name:CAIN, TAMMY SUE (DTH-CPP, BCCC, BCPC)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:SUE
Last Name:CAIN
Suffix:
Gender:F
Credentials:DTH-CPP, BCCC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 E SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4042
Mailing Address - Country:US
Mailing Address - Phone:208-358-8626
Mailing Address - Fax:
Practice Address - Street 1:1324 E SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4042
Practice Address - Country:US
Practice Address - Phone:208-358-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty