Individual
GEWYL KASY TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, NCC
Contact information
Practice address
242 E BROAD ST, STATESVILLE, NC 28677-5325
(980) 430-9205
Mailing address
242 E BROAD ST, STATESVILLE, NC 28677-5325
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17352
NC
Other
Enumeration date
02/11/2022
Last updated
01/07/2025
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