Provider Demographics
NPI:1952716193
Name:DR TAMMY SALTZMAN-GORN, PSYD LLC
Entity type:Organization
Organization Name:DR TAMMY SALTZMAN-GORN, PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZMAN-GORN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:941-929-5512
Mailing Address - Street 1:1783 FORTUNA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5910
Mailing Address - Country:US
Mailing Address - Phone:941-929-5512
Mailing Address - Fax:
Practice Address - Street 1:3665 BEE RIDGE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1054
Practice Address - Country:US
Practice Address - Phone:941-929-5512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8578103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty