Provider Demographics
NPI:1982095204
Name:MUZZY, TACY (MS)
Entity Type:Individual
Prefix:
First Name:TACY
Middle Name:
Last Name:MUZZY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 W QUINAULT AVE STE F202
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8210
Mailing Address - Country:US
Mailing Address - Phone:509-579-0200
Mailing Address - Fax:509-232-0216
Practice Address - Street 1:8121 W QUINAULT AVE STE F202
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8210
Practice Address - Country:US
Practice Address - Phone:509-579-0200
Practice Address - Fax:509-232-0216
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60884987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health