MEDICARE: TAMMY SMITH LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	74452	TX

General Provider Information

NPI Number	:	1215469796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY SMITH LPC

Provider Business Mailing Address
First Line	:	4211 W I 40 STE 101
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-6000
Country	:	US
Telephone Number	:	806-350-3133
Fax Number	:	806-358-4345

Provider Business Practice Location Address
First Line	:	4211 W I 40 STE 101
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-6000
Country	:	US
Telephone Number	:	806-350-3133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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Directions to “ TAMMY SMITH LPC” Practice Location

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