Provider Demographics
NPI:1649491010
Name:TANG-MORGAN, JACQUELINE M (PHD)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:M
Last Name:TANG-MORGAN
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:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37077-1155
Mailing Address - Country:US
Mailing Address - Phone:615-822-1222
Mailing Address - Fax:615-855-8306
Practice Address - Street 1:131 SANDERS FERRY RD STE 203
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3662
Practice Address - Country:US
Practice Address - Phone:615-822-1222
Practice Address - Fax:615-822-8306
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical