Provider Demographics
NPI:1386466019
Name:SYMONDS, TAMMYMARIE VICTORIA
Entity type:Individual
Prefix:
First Name:TAMMYMARIE
Middle Name:VICTORIA
Last Name:SYMONDS
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 1:401 ZANTE WAY
Mailing Address - Street 2:
Mailing Address - City:LOCHBUIE
Mailing Address - State:CO
Mailing Address - Zip Code:80603-9793
Mailing Address - Country:US
Mailing Address - Phone:720-665-8923
Mailing Address - Fax:
Practice Address - Street 1:401 ZANTE WAY
Practice Address - Street 2:
Practice Address - City:LOCHBUIE
Practice Address - State:CO
Practice Address - Zip Code:80603-9793
Practice Address - Country:US
Practice Address - Phone:720-665-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician