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General NPI Number Information
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NPI Number | 1821189069
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Entity Type | Individual
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Provider Name | MISS TAMARA SEABROOK
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | USAMEDDAC WUERZBURG EDIS-ANSBACH 235TH BSB UNIT 28614
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City | APO
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State | AE
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Zip | 09177
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Country | DE
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Telephone | 01149981183811
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Fax | 01149981183854
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Provider Business Mailing Address
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Address Line | USAMEDDAC WUERZBERG ATTN:CREDENTIALS OFFICE UNIT 26610
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City | APO
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State | AE
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Zip | 09244
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Country | DE
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Telephone | 011499318043616
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Fax | 011499318043241
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA6076
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License Number State | FL
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