Provider Demographics
NPI:1245469030
Name:MAYS, TAMARA JOANNE (MS, CCC-SLP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:JOANNE
Last Name:MAYS
Suffix:
Gender:F
Credentials:MS, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:JOANNE
Other - Last Name:SCAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2033 SALAMANCA ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566
Mailing Address - Country:US
Mailing Address - Phone:850-612-3030
Mailing Address - Fax:850-398-8297
Practice Address - Street 1:103 LEWIS ST STE A
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-3142
Practice Address - Country:US
Practice Address - Phone:850-612-3030
Practice Address - Fax:850-398-8297
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
FLSA10652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherTRICARE
FL001254100Medicaid