Provider Demographics
NPI:1154983302
Name:LEWIS, TAMARI CHARNEE (SLP)
Entity type:Individual
Prefix:
First Name:TAMARI
Middle Name:CHARNEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BRYCE BRANCH CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-5810
Mailing Address - Country:US
Mailing Address - Phone:951-741-0024
Mailing Address - Fax:
Practice Address - Street 1:82 N PINTO POINT CIR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-4396
Practice Address - Country:US
Practice Address - Phone:713-389-4159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115401235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist