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Individual
HAROLD TACUBOY
Active
Individual
HAROLD TACUBOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041398098
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.015542
IL
Other
Enumeration date
01/24/2012
Last updated
03/11/2019
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