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NPI Code Detail

MEDICARE: TAMMY J POSTLETHWAIT CDCA

MEDICARE: TAMMY J POSTLETHWAIT CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.181827OH

General Provider Information

NPI Number : 1558047688
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY J POSTLETHWAIT CDCA
Provider Business Mailing Address
First Line : 126 9TH ST NW APT B
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-1503
Country : US
Telephone Number : 309-489-7508
Fax Number :
Provider Business Practice Location Address
First Line : 543 W HIGH AVE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-2005
Country : US
Telephone Number : 309-489-7508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 06/23/2023

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