Healthcare Provider Details
I. General information
NPI: 1245534874
Provider Name (Legal Business Name): TAMARA DAWN DENBESTEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/22/2010
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 E CHATHAM ST
CARY NC
27511-3458
US
IV. Provider business mailing address
222 E CHATHAM ST
CARY NC
27511-3458
US
V. Phone/Fax
- Phone: 919-573-6544
- Fax: 919-573-6554
- Phone: 919-573-6544
- Fax: 919-573-6554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 4035 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: