Individual
DOMEKA HUBERT TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
3320 BEULAH RIDGE CT, LITHIA SPRINGS, GA 30122-2101
(678) 439-4362
Mailing address
3320 BEULAH RIDGE CT, LITHIA SPRINGS, GA 30122-2101
(678) 439-4362
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
CN0030082643
GA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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