Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | TX |
NPI | 1295120731 |
---|---|
Provider Name | Tammy Nnamani |
First Address | Dallas, TX 75247-3832 |
Second Address | Dallas, TX 75247-3832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 12/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
QMP000004721735 | MCO (01) | TX |