| NPI | 1790035012 |
|---|---|
| Former Name | TAMARA LEE SCAGGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2285565) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 5106) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2019-02-11 |