Individual
JOHNQUELL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
6815 W CAPITOL DR, MILWAUKEE, WI 53216-2070
(414) 231-3225
Mailing address
3530 N 56TH ST, MILWAUKEE, WI 53216-2816
(414) 241-7015
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134941121
WI
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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