Provider Demographics
NPI:1699262352
Name:DOCKERY, TAMMIE JULIET (MED,CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:JULIET
Last Name:DOCKERY
Suffix:
Gender:F
Credentials:MED,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 VAUXHALL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3557
Mailing Address - Country:US
Mailing Address - Phone:804-363-6374
Mailing Address - Fax:
Practice Address - Street 1:301 N NINTH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1933
Practice Address - Country:US
Practice Address - Phone:804-363-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist