Provider Demographics
NPI:1982854576
Name:TRAMMEL-YEBOAH, TENECIA N (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TENECIA
Middle Name:N
Last Name:TRAMMEL-YEBOAH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 PAYLOR LN STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-2207
Mailing Address - Country:US
Mailing Address - Phone:941-400-3493
Mailing Address - Fax:
Practice Address - Street 1:5319 PAYLOR LN STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-2207
Practice Address - Country:US
Practice Address - Phone:941-400-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA19966235Z00000X
NMSLP7700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist