Provider Demographics
NPI:1134334154
Name:PRETER, TAMMY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:PRETER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 S KERLEY WAY
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-2626
Mailing Address - Country:US
Mailing Address - Phone:352-628-3328
Mailing Address - Fax:
Practice Address - Street 1:7647 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-7962
Practice Address - Country:US
Practice Address - Phone:352-795-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist