MEDICARE: TAMMY D MURILLO LSCSW

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	1041C0700X	Clinical Social Worker	05915	KS

General Provider Information

NPI Number	:	1477943702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY D MURILLO LSCSW

Provider Business Mailing Address
First Line	:	2920 N BELMONT PL
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-7325
Country	:	US
Telephone Number	:	620-276-9468
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 N BELMONT PL
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-7325
Country	:	US
Telephone Number	:	620-276-9468
Fax Number	:

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	04/03/2025

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