Individual
LISA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 W COLTON AVE, REDLANDS, CA 92374-3106
(909) 478-4442
Mailing address
314 W COLTON AVE, REDLANDS, CA 92374-3106
(909) 478-4442
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
16849
CA
Other
Enumeration date
04/23/2019
Last updated
10/08/2024
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