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Individual

CAROLYN JEAN TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17 PACIFIC ST, ST AUGUSTINE, FL 32084-2753
(904) 501-5771
Mailing address
203 PRINCE RD, ST AUGUSTINE, FL 32086-4904
(904) 501-5771

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH5404
FL
106H00000X
Marriage & Family Therapist
MT1868
FL

Other

Enumeration date
05/15/2007
Last updated
09/11/2025
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