Provider Demographics
NPI:1346083730
Name:MILBOURNE, TAMMIE
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:MILBOURNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 EASTERN SHORE DR STE B
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5940
Mailing Address - Country:US
Mailing Address - Phone:443-736-7721
Mailing Address - Fax:
Practice Address - Street 1:614 EASTERN SHORE DR STE B
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5940
Practice Address - Country:US
Practice Address - Phone:443-736-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor