Individual
DANIELLE ELIZABETH TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADULT PEER SUPPORT
Contact information
Practice address
1439 S BROOK ST APT 4, LOUISVILLE, KY 40208-2043
(502) 684-1371
Mailing address
1439 S BROOK ST APT 4, LOUISVILLE, KY 40208-2043
(502) 684-1371
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
T99251564
KY
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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