Individual
MRS. TAMMY SUE OOTHOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 SOUTH LITTLE FOX TRAIL, CAMP VERDE, AZ 86322
(928) 301-2264
Mailing address
P.O. BOX 2554, CAMP VERDE, AZ 86322
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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