Individual
MRS. JANETTE THANH TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC- SLP
Contact information
Practice address
1064 WATERSIDE DR, SARATOGA SPRINGS, UT 84045-8152
(801) 850-6712
Mailing address
1064 WATERSIDE DR, SARATOGA SPRINGS, UT 84045-8152
(801) 850-6712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP12517
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1348076
DRIVER LICENSE
CA
Enumeration date
06/07/2010
Last updated
06/07/2010
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