Provider Demographics
NPI:1346836020
Name:TUCKMAN PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:TUCKMAN PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:484-356-6747
Mailing Address - Street 1:203 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2517
Mailing Address - Country:US
Mailing Address - Phone:610-430-1430
Mailing Address - Fax:610-344-7760
Practice Address - Street 1:203 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2517
Practice Address - Country:US
Practice Address - Phone:610-430-1430
Practice Address - Fax:610-344-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty