Individual
JESSIKA LEE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.; CCC-SLP
Contact information
Practice address
4909 WATERS EDGE DR, RALEIGH, NC 27606-2462
(919) 285-1647
Mailing address
2142 COMMONWEALTH AVE APT 426, CHARLOTTE, NC 28205-5177
(704) 408-4061
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
30001681
NC
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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