Provider Demographics
NPI:1386778082
Name:CHRISTENSEN, TAMMY RAY (EDS LPC NCC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:RAY
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:EDS LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:MO
Mailing Address - Zip Code:64755
Mailing Address - Country:US
Mailing Address - Phone:417-394-2777
Mailing Address - Fax:
Practice Address - Street 1:100 S PREWITT
Practice Address - Street 2:ALLIED MENTAL HEALTH ASSOCIATES
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772
Practice Address - Country:US
Practice Address - Phone:417-667-8700
Practice Address - Fax:417-667-7382
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006022863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health