Doctor Name: | PROF. IRVING TUCKER |
NPI Number: | 1720390461 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 361 |
Business Practice Address: | 418 East German Street Shepherdstown, WV - 254430119 |
Business Phone Number: | 3048763067 |
Business Fax Number: | |
Mailing Address: | Po Box 119, SHEPHERDSTOWN |
State: | WV |
Postal Code: | 254430119 |
Phone Number: | 3048763067 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2010 |
NPI Last Update Date: | 07/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 361 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |