Organization
MILICIA TEDDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILICIA TEDDER (LICENSED PSYCHOLOGICAL ASSOCIATE)
(919) 697-1674
Entity
Organization
Contact information
Practice address
2004 SPRING CREEK DR, DURHAM, NC 27704-4795
(919) 697-1674
Mailing address
2004 SPRING CREEK DR, DURHAM, NC 27704-4795
(919) 697-1674
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3735
NC
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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