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Individual

MRS. TAMARA LEE WYMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
2206 MITCHELL PARK DR, UNIT 14, PETOSKEY, MI 49770-8674
(231) 348-7777
(231) 348-3177
Mailing address
2206 MITCHELL ST., PETOSKEY, MI 49770-8674
(231) 348-7777
(231) 348-3177

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OP61310
PTAN
MI
Enumeration date
04/21/2009
Last updated
04/21/2009
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