Provider Demographics
NPI:1972775732
Name:BOYER, TAMARA LEE
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LEE
Last Name:BOYER
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 1:4470 S LEMAY AVE APT 323
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4821
Mailing Address - Country:US
Mailing Address - Phone:970-449-3431
Mailing Address - Fax:
Practice Address - Street 1:2627 REDWING RD STE 220
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6331
Practice Address - Country:US
Practice Address - Phone:970-449-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW 20921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical