Healthcare Provider Details

I. General information

NPI: 1285716233
Provider Name (Legal Business Name): TAMMY DUKEWICH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 21ST AVE S SUITE 1100
NASHVILLE TN
37212-3160
US

IV. Provider business mailing address

3107 WELLINGTON AVENUE APT. A
NASHVILLE TN
37212
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-8701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: