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Individual
STACY W TUCKER
Active
Individual
STACY W TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
022038-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2011
Last updated
10/23/2014
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