Provider Demographics
NPI:1437927811
Name:STORIE, TAMMY RENEE (SLP-A)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:STORIE
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 EASTLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-3702
Mailing Address - Country:US
Mailing Address - Phone:573-842-8111
Mailing Address - Fax:
Practice Address - Street 1:286 EASTLAWN AVE
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-3702
Practice Address - Country:US
Practice Address - Phone:573-842-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130434452355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant