Healthcare Provider Details

I. General information

NPI: 1720357502
Provider Name (Legal Business Name): TAMEKA HAMER BSW, MSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 01/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 COVE PL
ATLANTA GA
30339-5203
US

IV. Provider business mailing address

PO BOX 825 SOLUTION SPECIFIC SERVICES/TAMEKA HAMER
SMYRNA GA
30081-0825
US

V. Phone/Fax

Practice location:
  • Phone: 815-670-8152
  • Fax:
Mailing address:
  • Phone: 815-670-8152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: