Individual
DR. TANYA MARIE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1713 MADISON AVE STE 200, WASHINGTON, MO 63090-4914
(636) 390-6020
(636) 390-6021
Mailing address
1713 MADISON AVE STE 200, WASHINGTON, MO 63090-4914
(636) 390-6020
(636) 390-6021
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2004015328
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144227356
—
MO
01
—
P00461427
RAILROAD MEDICARE
—
01
—
P01152556
RAILROAD MEDICARE
MO
Enumeration date
07/01/2005
Last updated
08/04/2025
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