Provider Demographics
NPI:1336253376
Name:SCHULTZ, TAMARA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:TAMARA
Middle Name:LYNN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 DOVE FOREST LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1224
Mailing Address - Country:US
Mailing Address - Phone:281-812-8075
Mailing Address - Fax:
Practice Address - Street 1:9810 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 190
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3502
Practice Address - Country:US
Practice Address - Phone:281-446-0371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist