Provider Demographics
NPI:1982930558
Name:COUNTS, TAMMY SUELLA
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUELLA
Last Name:COUNTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 NW 70TH ST
Mailing Address - Street 2:APT. 308
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-3821
Mailing Address - Country:US
Mailing Address - Phone:913-302-4600
Mailing Address - Fax:
Practice Address - Street 1:6404 NW 70TH ST
Practice Address - Street 2:APT. 308
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-3821
Practice Address - Country:US
Practice Address - Phone:913-302-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging