Provider Demographics
NPI:1922376144
Name:PERSON, TAMERA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:MARIE
Last Name:PERSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 NW HIGH POINT DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-1984
Mailing Address - Country:US
Mailing Address - Phone:816-525-4385
Mailing Address - Fax:
Practice Address - Street 1:956 NW HIGH POINT DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-1984
Practice Address - Country:US
Practice Address - Phone:816-525-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8267104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker