Pourmotabbed, Tahere

Pourmotabbed, Tahere is an individual health care provider with primary practice located at 8110 Cordova Rd , Cordova TN 38016-0520. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pourmotabbed, Tahere can be contacted via phone (901) 757-0568.

Contact Information

Primary practice address
8110 Cordova Rd Cordova TN 38016-0520
Phone: (901) 757-0568
Fax: (901) 754-8247
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X P0000002344 Tennessee

Profile Details

NPI number 1649343765
LBN Legal business name Pourmotabbed, Tahere
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649343765 NPPES
Tennessee Other 4094352 BCBS OF TN
Tennessee MEDICAID 3387193 BCBS OF TN

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