Provider Demographics
NPI:1811673965
Name:MONTEIRO, TAMMY MARIE (LMT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RODNEY ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744-2222
Mailing Address - Country:US
Mailing Address - Phone:267-455-2710
Mailing Address - Fax:
Practice Address - Street 1:30 RODNEY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744-2222
Practice Address - Country:US
Practice Address - Phone:267-455-2710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17411225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist