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Contact Information

TAMARA M WILDGOOSE, PHD
1201 BROAD ROCK BLVD
RICHMOND, VA23249-3115
 Phone: 804-675-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for TAMARA M WILDGOOSE · (Female)

NPI # 1154663151
Status Active
Credentials PHD
Entity Individual
Enumeration date 03/18/2013
Last updated 05/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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