Individual
MARY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
14366 SOMMERVILLE CT, MIDLOTHIAN, VA 23113-6838
(804) 601-6010
(804) 601-4774
Mailing address
4560 SOUTH BLVD, SUITE 310, VIRGINIA BEACH, VA 23452-1160
(757) 490-3223
(757) 490-2936
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006928
VA
Other
Enumeration date
05/09/2016
Last updated
07/01/2019
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