Willmore, Tamara Lane

Willmore, Tamara Lane is an individual health care provider with primary practice located at 409 E Park St , Benton IL 62812-1920. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Willmore, Tamara Lane can be contacted via phone (618) 439-7231.

Contact Information

Primary practice address
409 E Park St Benton IL 62812-1920
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 146005821 Illinois

Profile Details

NPI number 1326567371
LBN Legal business name Willmore, Tamara Lane
Credentials M.S., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2017
Last updated Sep 11th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326567371 NPPES
Illinois MEDICAID 1609901784

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