Individual
MR. TIMREQUS TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
84 SANFORD RD, COURTLAND, MS 38620-9406
(901) 239-1705
Mailing address
84 SANFORD RD, COURTLAND, MS 38620-9406
(901) 239-1705
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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