Individual
CLAUDETTE M TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4858
(706) 432-3780
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4858
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
RN095280
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317B
—
GA
Enumeration date
09/10/2008
Last updated
09/10/2008
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