Provider Demographics
NPI:1962550558
Name:FEREBEE, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:FEREBEE
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:PO BOX 4844
Mailing Address - Street 2:
Mailing Address - City:EMERALD ISLE
Mailing Address - State:NC
Mailing Address - Zip Code:28594-4844
Mailing Address - Country:US
Mailing Address - Phone:252-354-2401
Mailing Address - Fax:
Practice Address - Street 1:910 BREMERTON DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6548
Practice Address - Country:US
Practice Address - Phone:252-412-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist