Tamara Kay Detloff
Individual provider Active NPI Behavior Technician · Perham, MN
NPI 1346914447 · NPPES record last updated Aug 3, 2021
Key facts
- NPI
- 1346914447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 316 6TH Ave SW
Perham, MN 56573-1508 - Phone
- (218) 346-2322
- Fax
- (218) 346-2323
- NPI assigned
- Aug 3, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowering Kids Perham | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
316 6TH Ave SW
Perham, MN 56573-1508
Mailing address
PO Box 452
Perham, MN 56573-0452
Phone (218) 346-2322
Other providers in Perham, MN
- Jessica Cooper
- David Dahl
- David R Smith, DDS, PA
- Makenzie K Davidson
- Jessica H Deleo
- Tonya L Diggins
- Carolyn Disse
- Hattie Rose Dorman
- Dr. Kelvin K. Salathe, P.C.
- Wanda Drewes
All providers in Perham, MN · Behavior Technician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.