1679883391 NPI number — TAMMY WOODRING-MALINICH MA, LPC, NCC

Table of content: TAMMY WOODRING-MALINICH MA, LPC, NCC (NPI 1679883391)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679883391 NPI number — TAMMY WOODRING-MALINICH MA, LPC, NCC

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
WOODRING-MALINICH

Provider First Name:
TAMMY

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:
MA, LPC, NCC

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:
WOODRING

Provider Other First Name:
TAMMY

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679883391

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
03/25/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3246 DRANE HIGHWAY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
OSCEOLA MILLS

Provider Business Mailing Address State Name:
PA

Provider Business Mailing Address Postal Code:
16666

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
814-577-0227

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1055 N FRONT ST

Provider Second Line Business Practice Location Address:
SPACE 13

Provider Business Practice Location Address City Name:
PHILIPSBURG

Provider Business Practice Location Address State Name:
PA

Provider Business Practice Location Address Postal Code:
16866-8258

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
814-577-0227

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:
10/15/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 101YP2500X , with the licence number: PC005634 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .