Individual
JUDITH I TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.S.W.
Contact information
Practice address
1660 NAVE RD SE, MASSILLON, OH 44646
(330) 837-9411
(330) 837-4603
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
S0018332
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0294096
—
OH
Enumeration date
01/15/2015
Last updated
08/20/2018
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