Healthcare Provider Details

I. General information

NPI: 1487312120
Provider Name (Legal Business Name): TAMMY GAIL KOTHE-RAMSEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 18TH ST STE B1
HONDO TX
78861-1753
US

IV. Provider business mailing address

12336 CLAIBORNE
SAN ANTONIO TX
78252-4414
US

V. Phone/Fax

Practice location:
  • Phone: 830-444-5064
  • Fax:
Mailing address:
  • Phone: 830-444-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number77235
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: