Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 06558 | MD |
Y | 103T00000X | Psychologist | 06558 | MD |
N | 102L00000X | Psychologist | PY8441 | FL |
N | 103T00000X | Psychologist | PY8441 | FL |
NPI | 1013191113 |
---|---|
Provider Name | Dorcia J Tucker |
First Address | Annapolis, MD 21404-0785 |
Second Address | Elkridge, MD 21075-7049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2007 |
Last Update Date | 16/12/2021 |