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General NPI Number Information
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NPI Number | 1265506190
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Entity Type | Individual
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Provider Name | TAMMY STAR LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 7777 N WICKHAM RD STE 12-224
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City | VIERA
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State | FL
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Zip | 32940-7976
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Country | US
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Telephone | 321-223-8003
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Fax | 321-452-2802
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Provider Business Mailing Address
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Address Line | 605 SHORT ST
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City | GREENSBURG
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State | PA
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Zip | 15601-5712
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Country | US
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Telephone | 321-223-8003
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Fax | 321-452-2802
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH7949
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License Number State | FL
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