Individual
MRS. JULIA S TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
162 B EAST MAIN STREET, CLINTON, CT 06413
(860) 575-0811
Mailing address
15 LONGATE ROAD, CLINTON, CT 06413
(860) 669-2250
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001034
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11244950
CAQH PROVIDER ID
CT
Enumeration date
05/02/2007
Last updated
07/08/2007
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