Individual
TAMMIE LYNN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW-CC
Contact information
Practice address
284 MAIN ST STE 280, WILTON, ME 04294-3044
(207) 200-8555
Mailing address
275 VARNUM POND RD, TEMPLE, ME 04984-3003
(207) 778-1080
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC24774
ME
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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