Provider Demographics
NPI:1245469022
Name:MORTON, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MORTON
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:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:SINCLAIR
Mailing Address - State:WY
Mailing Address - Zip Code:82334-0371
Mailing Address - Country:US
Mailing Address - Phone:307-321-2938
Mailing Address - Fax:
Practice Address - Street 1:25 WATER TREATMENT RD
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301
Practice Address - Country:US
Practice Address - Phone:307-321-2938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No171M00000XOther Service ProvidersCase Manager/Care Coordinator