Provider Demographics
NPI:1114076536
Name:TUCKER, DENISE ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANNE
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 1:300 FERGUSON BUILDING
Mailing Address - Street 2:UNIVERSITY OF NORTH CAROLINA GREENSBORO
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-6170
Mailing Address - Country:US
Mailing Address - Phone:336-334-5284
Mailing Address - Fax:
Practice Address - Street 1:300 FERGUSON BUILDING
Practice Address - Street 2:UNIVERSITY OF NORTH CAROLINA GREENSBORO
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402-6170
Practice Address - Country:US
Practice Address - Phone:336-334-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3032231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist