Individual
TINA STUCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 EVANS AVE, VALPARAISO, IN 46383-6939
(219) 462-0786
(219) 548-7543
Mailing address
2801 EVANS AVE, VALPARAISO, IN 46383-6940
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004929A
—
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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