Provider Demographics
NPI:1730591934
Name:TAMAYAO, KARA
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:TAMAYAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 N HIGHVIEW LN
Mailing Address - Street 2:#301
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-2308
Mailing Address - Country:US
Mailing Address - Phone:224-715-9503
Mailing Address - Fax:
Practice Address - Street 1:6354 ROLLING MILL PL
Practice Address - Street 2:#103
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2369
Practice Address - Country:US
Practice Address - Phone:703-866-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007397235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist