Individual
MRS. LISA V TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 MAIN ST STE 231, STRATFORD, CT 06615-5839
(203) 375-5782
(203) 375-3048
Mailing address
2505 MAIN ST STE 231, STRATFORD, CT 06615-5839
(203) 375-5782
(203) 375-3048
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/21/2015
Last updated
03/19/2019
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