Provider Demographics
NPI:1992042261
Name:KAUDER, TAMARA B (SLP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:B
Last Name:KAUDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 PARK HILL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3375
Mailing Address - Country:US
Mailing Address - Phone:540-446-2654
Mailing Address - Fax:540-656-2755
Practice Address - Street 1:321 PARK HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3375
Practice Address - Country:US
Practice Address - Phone:540-446-2654
Practice Address - Fax:540-656-2755
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist