Individual
MRS. TAMMY LYNN STREETER-SPATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
622 S MEMORIAL DR, GREENVILLE, NC 27834-2854
(252) 353-4250
(252) 353-4228
Mailing address
622 S MEMORIAL DR, GREENVILLE, NC 27834-2854
(252) 353-4250
(252) 353-4228
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
412
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6110504
—
NC
Enumeration date
09/26/2006
Last updated
07/08/2007
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