Individual
TAMARA ROSE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
416 E FOURTH ST, LONG BEACH, MS 39560-6211
(228) 234-7988
Mailing address
416 E FOURTH ST, LONG BEACH, MS 39560-6211
(228) 234-7988
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0894
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SO894
MISSISSIPPI STATE LICENSURE
MS
Enumeration date
07/13/2018
Last updated
07/13/2018
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