Individual
TAMMY S PENTECOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
308 BARNES RD, WILLIAMSTOWN, KY 41097-9483
(859) 824-4442
(859) 824-4448
Mailing address
PO BOX 2680, COVINGTON, KY 41012-2680
(859) 824-4442
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5549
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
04/25/2012
Last updated
04/25/2012
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