Provider Information for 1700830841
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TAMMIE ERVIN LCSW
Sex: Female
NPI: 1700830841
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1700830841 | ||||||||||||
| Enumeration Date | 2006-05-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 107 CRANES ROOST CT ELIZABETHTOWN, KY 42701-3650 United States Phone: 270-765-2605 | Fax:270-766-1222 | ||||||||||||
| Primary Practice Address | 607 OLD HIGHWAY 60 HARDINSBURG, KY 40143-2511 United States Phone: 270-756-5816 | Fax:270-756-5815 | ||||||||||||
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