Provider Demographics
NPI:1053664540
Name:TUCKER, TAMEKA MALLARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:TAMEKA
Middle Name:MALLARD
Last Name:TUCKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 PENDLETON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1820
Mailing Address - Country:US
Mailing Address - Phone:703-786-5486
Mailing Address - Fax:703-842-8246
Practice Address - Street 1:709 PENDLETON ST STE 202
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1820
Practice Address - Country:US
Practice Address - Phone:703-786-5486
Practice Address - Fax:703-842-8746
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist