Provider Demographics
NPI:1235330317
Name:NEULICHT, ANN TAMARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:TAMARA
Last Name:NEULICHT
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:7413 SIX FORKS RD
Mailing Address - Street 2:#174
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6164
Mailing Address - Country:US
Mailing Address - Phone:919-870-6048
Mailing Address - Fax:919-870-6048
Practice Address - Street 1:7413 SIX FORKS RD
Practice Address - Street 2:#174
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6164
Practice Address - Country:US
Practice Address - Phone:919-870-6048
Practice Address - Fax:919-870-6048
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2009-06-01
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Provider Licenses
StateLicense IDTaxonomies
NC1089173000000X, 225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor