Tucker, Terry
Tucker, Terry is an individual health care provider with primary practice located at 1441 S Saint Francis Dr , Santa Fe NM 87505-4037. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Tucker, Terry can be contacted via phone (505) 982-2177.Contact Information
Primary practice address
1441 S Saint Francis Dr
Santa Fe NM 87505-4037
Phone: (505) 982-2177
Fax: (505) 982-0620
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3918 | New Mexico |
Profile Details
| NPI number | 1104018027 |
|---|---|
| LBN Legal business name | Tucker, Terry |
| Credentials | LADAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2007 |
| Last updated | Sep 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104018027 | NPPES |
| New Mexico | MEDICAID | 54659566 |
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