Provider Demographics
NPI:1972016699
Name:LAWRENCE, TAMARA
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 UMI ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:877-376-3335
Practice Address - Street 1:2959 UMI ST STE 300
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1806
Practice Address - Country:US
Practice Address - Phone:808-635-4361
Practice Address - Fax:877-376-3335
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst