Provider Demographics
NPI:1174894893
Name:MARTIN, TAMARA (MHR)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:MRS
Other - First Name:TAMARA
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1401 WILLIAMS ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-1101
Mailing Address - Country:US
Mailing Address - Phone:423-702-5508
Mailing Address - Fax:
Practice Address - Street 1:1401 WILLIAMS ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1101
Practice Address - Country:US
Practice Address - Phone:423-702-5508
Practice Address - Fax:423-702-5512
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor