Basic Information
| Provider Information | |||||||||
| NPI: | 1871577148 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANCAMP | ||||||||
| FirstName: | TAMI | ||||||||
| MiddleName: | URBANI | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PHD SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 MILL ST MS M14 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759825262 | ||||||||
| FaxNumber: | 7759823900 | ||||||||
| Practice Location | |||||||||
| Address1: | 1664 N VIRGINIA ST MS 152 | ||||||||
| Address2: | REDFIELD MEDICAL BUILDING | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895570152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759821000 | ||||||||
| FaxNumber: | 7759823900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP366 | NV | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | DA159Y | 01 | NV | MEDICARE PTAN# | OTHER | NPI# 1871577148 | 05 | NV | MEDICAID |