Healthcare Provider Details

I. General information

NPI: 1457464505
Provider Name (Legal Business Name): TAMARA ANN MORROW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4413 CORUNNA RD
FLINT MI
48532-4321
US

IV. Provider business mailing address

1110 ELDON BAKER DR
FLINT MI
48507-1923
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-0900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801065454
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: