Individual
BIANCA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5198 RICHMOND RD, BEDFORD HEIGHTS, OH 44146-1331
(216) 378-9101
Mailing address
12339 WAKE UNION CHURCH RD, WAKE FOREST, NC 27587-4512
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101663
—
OH
Enumeration date
08/07/2017
Last updated
08/07/2017
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