Tamara Puddy

Individual provider Active NPI Intellectual & Developmental Disabilities Psychologist · Rocky Mount, NC

NPI 1609172121 · NPPES record last updated Jan 31, 2011

Key facts

NPI
1609172121
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Practice address
415 Ansley St
Rocky Mount, NC 27803-2104
Phone
(252) 885-1285
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X NC Yes

Addresses

Primary practice location

415 Ansley St
Rocky Mount, NC 27803-2104

Mailing address

415 Ansley St
Rocky Mount, NC 27803-2104
Phone (252) 885-1285

Other providers in Rocky Mount, NC

All providers in Rocky Mount, NC · Intellectual & Developmental Disabilities Psychologist in North Carolina

Sources for this page

Verify at the official NPI Registry.