Healthcare Provider Details

I. General information

NPI: 1871962035
Provider Name (Legal Business Name): TAMMY LAWRENCE M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 W SAVANNAH RIDGE RD
HOLLY SPRINGS NC
27540-7378
US

IV. Provider business mailing address

148 W SAVANNAH RIDGE RD
HOLLY SPRINGS NC
27540-7378
US

V. Phone/Fax

Practice location:
  • Phone: 203-752-6235
  • Fax:
Mailing address:
  • Phone: 203-752-6235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30002166
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: