Provider Demographics
NPI:1013463066
Name:WILLS, TAMMY L (NCC, DCC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:L
Last Name:WILLS
Suffix:
Gender:F
Credentials:NCC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 984
Mailing Address - Street 2:
Mailing Address - City:KIMBERTON
Mailing Address - State:PA
Mailing Address - Zip Code:19442-0984
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 HUNT LN
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2012
Practice Address - Country:US
Practice Address - Phone:484-744-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health