Individual
MALLORY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
96 GRASSO PLZ, SAINT LOUIS, MO 63123-3108
(636) 398-2515
(800) 687-5070
Mailing address
4721 S CLIFF AVE STE 103, INDEPENDENCE, MO 64055-6969
(816) 608-1956
(800) 687-5070
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-307541
—
Other
Enumeration date
10/28/2022
Last updated
01/17/2025
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