Healthcare Provider Details

I. General information

NPI: 1982617189
Provider Name (Legal Business Name): MAUREEN E. TIERNAN-MEECH PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 W. HANLEY AVE STE 101
COEUR D'ALENE ID
83815-8994
US

IV. Provider business mailing address

509 W. HANLEY AVE STE 101
COEUR D'ALENE ID
83815-8994
US

V. Phone/Fax

Practice location:
  • Phone: 208-666-0357
  • Fax: 208-666-0468
Mailing address:
  • Phone: 208-666-0357
  • Fax: 208-666-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY5568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: