Provider Demographics
NPI:1104006956
Name:SALTZMAN-GORN, TAMMY (PSYD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:SALTZMAN-GORN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1783 FORTUNA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5910
Mailing Address - Country:US
Mailing Address - Phone:941-929-5512
Mailing Address - Fax:
Practice Address - Street 1:3665 BEE RIDGE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1054
Practice Address - Country:US
Practice Address - Phone:941-312-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8578103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical