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Individual
TAMMI Y. ISHIMATSU
Active
Individual
TAMMI Y. ISHIMATSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
335924-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33592435000001
BLUE CROSS
UT
Enumeration date
01/31/2006
Last updated
11/16/2015
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