Individual
CAROLYN ROSE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1009 MILSTEAD AVE NE STE 210, CONYERS, GA 30012-4510
(770) 789-0847
Mailing address
2424 SANTA BARBRA CT SE, CONYERS, GA 30013-2006
(770) 789-0847
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC007670
GA
Other
Enumeration date
11/17/2011
Last updated
01/28/2014
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