Provider Demographics
NPI:1982111472
Name:BENDER, TAMARA KAY (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:KAY
Last Name:BENDER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-1376
Mailing Address - Country:US
Mailing Address - Phone:740-343-0733
Mailing Address - Fax:740-342-2914
Practice Address - Street 1:106 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1376
Practice Address - Country:US
Practice Address - Phone:740-343-0733
Practice Address - Fax:740-342-2914
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH165638101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)