Provider Demographics
NPI:1922431204
Name:HARTLEY, TAMI LEE (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:LEE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14783 W. LUCAS LN.
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9619
Mailing Address - Country:US
Mailing Address - Phone:602-574-3980
Mailing Address - Fax:
Practice Address - Street 1:14783 W LUCAS LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9619
Practice Address - Country:US
Practice Address - Phone:602-574-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA83732355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant