Provider Demographics
NPI:1023194511
Name:TUCKER, ABIGAIL SARAH (PSY D)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:SARAH
Last Name:TUCKER
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8989 HURON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6858
Mailing Address - Country:US
Mailing Address - Phone:303-853-3703
Mailing Address - Fax:303-853-3754
Practice Address - Street 1:8989 HURON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80260-6858
Practice Address - Country:US
Practice Address - Phone:303-853-3703
Practice Address - Fax:303-853-3754
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CO3293103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor