Individual
TAMMY DEMORIA BLACKMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-4783
(228) 523-4384
Mailing address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-4783
(228) 523-4384
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4037C
AL
104100000X
Social Worker
Primary
C9233
MS
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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