Individual
TAMA HENNIGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, QIDP, QMHP
Contact information
Practice address
5805 CEDAR LAKE RD, OSCODA, MI 48750-9499
(989) 739-1469
Mailing address
5805 CEDAR LAKE RD, OSCODA, MI 48750-9499
(989) 739-1469
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
05/02/2018
Last updated
02/05/2021
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