Provider Demographics
NPI:1457568917
Name:ROBERTS, TAMMY PATRICIA (RC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:PATRICIA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 CANTERBURY LN #40
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-756-0033
Mailing Address - Fax:
Practice Address - Street 1:3725 CANTERBURY LN APT 40
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1180
Practice Address - Country:US
Practice Address - Phone:360-756-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health