Provider Demographics
NPI:1316300148
Name:OLDS, TAMMY ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:ANN
Last Name:OLDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 OWINGS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-9361
Mailing Address - Country:US
Mailing Address - Phone:406-381-9250
Mailing Address - Fax:
Practice Address - Street 1:262 OWINGS CREEK RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-9361
Practice Address - Country:US
Practice Address - Phone:406-381-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-167061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical