Individual
MR. MARK TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 W PINHOOK RD STE 402, LAFAYETTE, LA 70508-3212
(337) 281-1545
Mailing address
2020 W PINHOOK RD STE 402, LAFAYETTE, LA 70508-3212
(337) 281-1545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1341
LA
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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