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Individual

MR. JOSHUA TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LICSW

Contact information

Practice address
11010 PRAIRIE LAKES DR STE 350, EDEN PRAIRIE, MN 55344-3801
(952) 746-2522
Mailing address
17088 ADELMANN ST SE APT 312, PRIOR LAKE, MN 55372-2281
(864) 918-0946

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25639
MN

Other

Enumeration date
11/17/2020
Last updated
11/17/2020
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