Brazeal, Tammy Jo
Brazeal, Tammy Jo is an individual health care provider with primary practice located at 102 Lillian , Crane MO 65633-9103. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Brazeal, Tammy Jo can be contacted via phone (417) 766-6996.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1999139460 | Missouri |
Profile Details
| NPI number | 1427054212 |
|---|---|
| LBN Legal business name | Brazeal, Tammy Jo |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Apr 13th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427054212 | NPPES |
| Missouri | MEDICAID | 494806516 |
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