Healthcare Provider Details

I. General information

NPI: 1952484891
Provider Name (Legal Business Name): TAMMY LEE CORBETT-ALDERMAN M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150-A COURT AVE.
HAMLIN WV
25523-1438
US

IV. Provider business mailing address

9 BROOKSHIRE DR
HUNTINGTON WV
25705-2655
US

V. Phone/Fax

Practice location:
  • Phone: 304-824-7776
  • Fax: 307-824-7776
Mailing address:
  • Phone: 304-736-1438
  • Fax: 304-736-1438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number895
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: