Individual
LAURA L TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1657 MERRIMAC TRL, WILLIAMSBURG, VA 23185-5624
(757) 220-3200
Mailing address
3972 LONGHILL STATION RD, WILLIAMSBURG, VA 23188-7368
(757) 345-0283
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0904002567
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945301
—
VA
01
—
184226
ANTHEM
VA
01
—
376989
VALUE OPTIONS
VA
01
—
O84181M
OPTIMA
VA
Enumeration date
01/09/2007
Last updated
07/08/2007
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