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Individual

MRS. TAMMY ANN EASTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED. S.

Contact information

Practice address
200 CENTER ST, MORIARTY, NM 87035
(505) 832-4421
(505) 832-4472
Mailing address
PO BOX 683, MORIARTY, NM 87035-0683
(208) 550-7559

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
12004920
CA

Other

Enumeration date
08/10/2012
Last updated
08/10/2012
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