Healthcare Provider Details

I. General information

NPI: 1982415170
Provider Name (Legal Business Name): TAMARA HOTCHKISS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY HOTCHKISS

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9514 CARING WAY
COLUMBIA IL
62236-3470
US

IV. Provider business mailing address

9514 CARING WAY
COLUMBIA IL
62236-3470
US

V. Phone/Fax

Practice location:
  • Phone: 618-281-9622
  • Fax:
Mailing address:
  • Phone: 618-281-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: