Provider Demographics
NPI:1356590756
Name:FRACTION, TAMMEKIA SHANDRA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TAMMEKIA
Middle Name:SHANDRA
Last Name:FRACTION
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 1:337 ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:AR
Mailing Address - Zip Code:72360-2140
Mailing Address - Country:US
Mailing Address - Phone:870-295-5280
Mailing Address - Fax:870-295-5390
Practice Address - Street 1:401 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:AR
Practice Address - Zip Code:72360-2102
Practice Address - Country:US
Practice Address - Phone:870-295-5280
Practice Address - Fax:870-295-5390
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist