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Individual
TAMMY KENDAL ELLISON
Active
Individual
TAMMY KENDAL ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
C-08200
NM
103K00000X
Behavior Analyst
Primary
X-06814
NM
Other
Enumeration date
11/24/2009
Last updated
06/11/2026
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