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NPI Code Detail

MEDICARE: DR. MARY CATHERINE TUCKER PHD

MEDICARE: DR. MARY CATHERINE TUCKER PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4226NC

General Provider Information

NPI Number : 1487813028
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY CATHERINE TUCKER PHD
Provider Business Mailing Address
First Line : 1511 COLLEGE OF EDUCATION
Second Line : INDIANA STATE UNIVERSITY
City : TERRE HAUTE
State : IN
Zip : 47809-0001
Country : US
Telephone Number : 812-237-2889
Fax Number : 812-237-2729
Provider Business Practice Location Address
First Line : 1511 COLLEGE OF EDUCATION
Second Line : INDIANA STATE UNIVERSITY
City : TERRE HAUTE
State : IN
Zip : 47809-0001
Country : US
Telephone Number : 812-237-2889
Fax Number : 812-237-2729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2008
Last Update Date : 06/09/2008

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