Tamara M Wildgoose
Rehabilitation Psychologist
1201 Broad Rock Blvd
Richmond
, Virginia 23249-3115
Tamara M Wildgoose
Rehabilitation Psychologist
1201 Broad Rock Blvd
Richmond
, Virginia 23249-3115
(804) 675-5000
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Tamara M Wildgoose
- 1201 Broad Rock Blvd
- Richmond, VA
- Zip : 23249-0001
- Phone : (804) 675-5000
Second Address
- Tamara M Wildgoose
- 1201 Broad Rock Blvd
- Richmond, VA
- Zip : 23249-3115
- Phone : (804) 675-5000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1154663151 |
|---|---|
| Provider Name | Tamara M Wildgoose |
| First Address | Richmond, VA 23249-0001 |
| Second Address | Richmond, VA 23249-3115 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/03/2013 |
| Last Update Date | 26/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.