Healthcare Provider Details

I. General information

NPI: 1871763789
Provider Name (Legal Business Name): TAMARA PERRY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 CONCORD PIKE SUITE 103
WILMINGTON DE
19803-3642
US

IV. Provider business mailing address

1521 CONCORD PIKE SUITE 103
WILMINGTON DE
19803-3642
US

V. Phone/Fax

Practice location:
  • Phone: 302-428-0205
  • Fax: 302-428-1123
Mailing address:
  • Phone: 302-428-0205
  • Fax: 302-428-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberB1-0000778
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: