Healthcare Provider Details

I. General information

NPI: 1932062635
Provider Name (Legal Business Name): TAMMY LAVERNE WOODBURY-BELLAMY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12805 PEACHLEAF CT
UPPER MARLBORO MD
20774-5602
US

IV. Provider business mailing address

12805 PEACHLEAF CT
UPPER MARLBORO MD
20774-5602
US

V. Phone/Fax

Practice location:
  • Phone: 240-600-8005
  • Fax:
Mailing address:
  • Phone: 240-600-8005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: