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Individual

DR. ADDYSON R TUCKER THAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X
Credential
PSYD

Contact information

Practice address
22 PARSONAGE ST # 159, PROVIDENCE, RI 02903-4758
(401) 216-7877
(401) 489-7909
Mailing address
22 PARSONAGE ST # 159, PROVIDENCE, RI 02903-4732
(401) 216-7877
(401) 489-7909

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
10739
MA
103TC0700X
Clinical Psychologist
Primary
PS01864
RI

Other

Enumeration date
03/14/2016
Last updated
11/11/2024
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